TY - JOUR
T1 - Longitudinal electroencephalographic (EEG) findings in pediatric anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis
T2 - The padua experience
AU - Nosadini, Margherita
AU - Boniver, Clementina
AU - Zuliani, Luigi
AU - De Palma, Luca
AU - Cainelli, Elisa
AU - Battistella, Pier Antonio
AU - Toldo, Irene
AU - Suppiej, Agnese
AU - Sartori, Stefano
PY - 2015
Y1 - 2015
N2 - To contribute to characterize electroencephalographic (EEG) activity in pediatric anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis, we reviewed electroclinical data of 5 children with anti-NMDA receptor encephalitis diagnosed in our department. We identified 4 longitudinal electroencephalographic phases: in the early phase, background activity was normal, with intermixed nonreactive slow waves; in the florid phase, background activity deteriorated with appearance of sequences of peculiar rhythmic theta and/or delta activity unrelated to clinical changes, unresponsive to stimuli and antiepileptic medications; in the recovery phase, these sequences decreased and reactive posterior rhythm re-emerged; electroencephalogram normalized 2 to 5 months after onset. In conclusion, in the presence of evocative clinical history, recognizing a characteristic longitudinal electroencephalographic activity could provide ancillary aspects addressing the diagnosis and the overall management of children with anti-N-methyl-D-aspartate receptor encephalitis; in particular, knowing that peculiar and recurrent paroxysmal nonepileptic rhythmic theta-delta patterns can occur in these patients could help distinguish paroxysmal epileptic and nonepileptic electroencephalographic activity.
AB - To contribute to characterize electroencephalographic (EEG) activity in pediatric anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis, we reviewed electroclinical data of 5 children with anti-NMDA receptor encephalitis diagnosed in our department. We identified 4 longitudinal electroencephalographic phases: in the early phase, background activity was normal, with intermixed nonreactive slow waves; in the florid phase, background activity deteriorated with appearance of sequences of peculiar rhythmic theta and/or delta activity unrelated to clinical changes, unresponsive to stimuli and antiepileptic medications; in the recovery phase, these sequences decreased and reactive posterior rhythm re-emerged; electroencephalogram normalized 2 to 5 months after onset. In conclusion, in the presence of evocative clinical history, recognizing a characteristic longitudinal electroencephalographic activity could provide ancillary aspects addressing the diagnosis and the overall management of children with anti-N-methyl-D-aspartate receptor encephalitis; in particular, knowing that peculiar and recurrent paroxysmal nonepileptic rhythmic theta-delta patterns can occur in these patients could help distinguish paroxysmal epileptic and nonepileptic electroencephalographic activity.
KW - Anti-NMDAR encephalitis
KW - Children
KW - EEG
KW - Rhythmic pattern
KW - Seizure
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U2 - 10.1177/0883073813515947
DO - 10.1177/0883073813515947
M3 - Article
C2 - 24396130
AN - SCOPUS:84903935368
VL - 30
SP - 238
EP - 245
JO - Journal of Child Neurology
JF - Journal of Child Neurology
SN - 0883-0738
IS - 2
ER -