Table 1 Clinical data of 12 patients with paraneoplastic anti-NMDA receptor encephalitis
NO | Sex/ age | Hospital stay/d | Prodromal symptom | Psychiatric symptoms | Seizure | Cognitive dysfunction | Speech dysfunction | Movement disorder | Consciousness decreased | Autonomic dysfunction | Central hypoventilation | MRI | EEG | CSF | Anti-NMDAR antibody | Immunotherapy | mRs of follow-up | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
CSF | Serum | |||||||||||||||||
N-1 | f/18 | 57 | Headache | Early irritability, manic, aggression and automutilation, disorganized, Late Psychomotor inhibition | GTCS SE | Yes | pressured speech and mutism | choreoathetoid movements | coma | hypotension | Yes | Normal | focal slow activity | Increased white blood cells | +++ | ++ | IVIG 5d * 2 | 0 (2.5 Year) |
N-2 | f/19 | 106 | Fever | hallucination, agitation, irritability | GTCS | Yes | pressured speech | Orofacial dyskinesia, Myoclonus | delirium, light coma | pyrexia | Yes | Bilateral temporal lobe meningeal thickening | diffuse slow activity and epileptic activity | Increased white blood cells | +++ | – | IVIG 5d * 2 Methylprednisolone | 0 (4.2 Year) |
N-3 | f/17 | 50 | Fever | Disorganized, agitation, manic, insomnia, hallucinations | GTCS | Yes | No | Orofacial dyskinesia | coma | No | No | Normal | epileptic activity | Increased white blood cells | ++ | +++ | IVIG 5d * 2 Methylprednisolone 1000 mg 5d | 0 (2.5 Year) |
N-4 | f/17 | 73 | Have a cold | Agitation, Hallucinations, Delusions | GTCS | Yes | No | No | coma | pyrexia, tachycardia | Yes | meningeal enhancement | focal slow activity | 0 | +++ | +++ | Methylprednisolone 500 mg 2d IVIG 20 g 5d*2 | 0 (5.5 Year) |
N-5 | f/28 | 70 | No | Agitation, Hallucinations, Delusions, automutilation | GTCS | Yes | gibberish-speaking | Orofacial dyskinesia, choreoathetoid movements | somnolence, deliration | No | Yes | Normal | diffuse slow activity and extreme delta brush | Increased white blood cells | +++ | ++ | IVIG 5d * 3 Methylprednisolone 1000 mg 3d | 1 (1.5 Year) |
N-6 | f/20 | 28 | Headache | Disorganized, agitation | CPS | Yes | No | Orofacial dyskinesia | light coma | tachycardia | Yes | – | diffuse slow activity and extreme delta brush | Increased white blood cells and Protein | +++ | _ | IVIG 5d * 3 Methylprednisolone 1000 mg 5d | 0 (2.4 Year) |
N-7 | f/22 | 27 | insomnia | Agitation, Hallucinations, Delusions, Disorganized, automutilation | CPS | Yes | No | Orofacial dyskinesia | No | urinary incontinence | No | Normal | diffuse slow activity | 0 | +++ | ++ | IVIG 5d Methylprednisolone 500 mg 5d | 0 (1.6 Year) |
N-8 | f/20 | 58 | numbness of fingers | No | SGTCS | Yes | No | finger spasm | No | No | No | Normal | focal slow activity | Increased white blood cells | +++ | ++ | IVIG 5d*2 | 1 (2 Year) |
N-9 | f/29 | 400 | Fever | Hallucinations | GTCS | Yes | – | Orofacial dyskinesia | coma | No | Yes | Abnormal signals in bilateral frontal and temporal lobe | focal slow activity and epileptic activity | Elevated pressure and increased white blood cells | +++ | ++ | IVIG 5d * 4 Rituximab 500 mg * 3 Methylprednisolone 1000 mg 5d | 1 (1 Year) |
N-10 | f/35 | 23 | No | Aggression, Disorganized, Agitation, Manic, Insomnia, Hallucinations, Psychomotor inhibition | CPS SE | Yes | mutism | No | coma | No | Yes | cerebral infarction in Splenium of Corpus Callosum, Right lateral ventricle enlargement | extreme delta brush | 0 | +++ | ++ | IVIG 5d | 0 (3.6 Year) |
N-11 | f/43 | 15 | No | Aggression, Disorganized, Agitation, Manic | GTCS | Yes | No | No | somnolence | No | No | Normal | diffuse slow activity and extreme delta brush | 0 | +++ | _ | IVIG 5d | 0 (2 Year) |
N-12 | m/25 | 113 | Have a cold | Disorganized, Agitation Manic | GTCS | Yes | disfluency | Orofacial dyskinesia | coma | pyrexia | Yes | Abnormal signals in bilateral temporal lobe and amygdala | Normal | Elevated pressure and increased white blood cells | +++ | + | IVIG 5d*2 | 6 |