Log In

Forgot Password?

OR

Not a member? Continue as a nonmember.

Become a Member

By becoming a member of the AAN, you can receive exclusive information to help you at every stage of your career. Benefits include:

Join Now See All Benefits

Loading... please wait

Abstract Details

Diagnostic Challenges in Pediatric Anti-NMDA Receptor Encephalitis
Autoimmune Neurology
P5 - Poster Session 5 (11:45 AM-12:45 PM)
6-011

Prompt treatment of anti-NMDAR encephalitis in pediatric patients is associated with improved outcomes, but diagnosis remains challenging. Heterogeneity in presentations, variability based on age, and broad differential diagnoses of associated symptoms in the pediatric population can complicate timely and accurate identification of the disease.

To describe the progression of symptoms, diagnostic testing, and encounters with the health care system that pediatric patients experience prior to receiving a confirmed diagnosis of anti-NMDAR encephalitis. 
A retrospective chart review for patients within Primary Children’s Hospital (PCH) was conducted. ICD10 code G04.81 at PCH between January 2007 to September 2022 was queried to identify pediatric patients with “other encephalitis”. Of these 147 pediatric patients, 18 had confirmed anti-NMDAR encephalitis based on clinical features and positive NMDAR Ig antibody testing in the cerebrospinal fluid
We identify a cohort of pediatric patients with confirmed anti-NMDAR encephalitis, and discuss duration and progression of symptoms, diagnostic testing, interventions, number of encounters within the health care system, and involved subspecialties prior to a final diagnosis being made. We also review characteristics associated with prolonged times to diagnosis. 

Pediatric patients with anti-NMDAR encephalitis often have an evolution of symptoms, extensive diagnostic evaluations, and multiple encounters with the healthcare system prior to confirmation of diagnosis. Factors associated with prolonged time until diagnosis may aid in identifying those at risk for diagnostic delays. Additionally, recognition of the path to diagnosis these children often take may help physicians better understand the challenges and stressors patients and families face, not only following a diagnosis of anti-NMDAR encephalitis, but also leading up to it. 

Authors/Disclosures
Melissa Ann Wright, MD (University of Utah)
PRESENTER
Dr. Wright has nothing to disclose.
Suzanne Liu, MD (University of Utah) The institution of an immediate family member of Dr. Liu has received research support from NIH.
Ka-Ho Wong (U of U Neurology Clinic) The institution of Mr. Wong has received research support from The Sumaira Foundation .
Sama Noroozi Gilandehi, MD Dr. Noroozi Gilandehi has nothing to disclose.
Sarah Shapiro (Kansas City University College of Osteopathic Medicine) Miss Shapiro has nothing to disclose.
Tammy L. Smith, MD, PhD (Imaging and Neurosciences Center) The institution of Dr. Smith has received research support from Alexion/AstraZeneca. Dr. Smith has a non-compensated relationship as a participant with Euroimmun Academy, receiving travel support to attend, that is relevant to AAN interests or activities.
Lisa Kay Peterson, PhD (ARUP Laboratories) The institution of Dr. Peterson has received research support from Kronus.
Stacey Clardy, MD, PhD, FAAN (University of Utah) Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Dr. Clardy has received personal compensation for serving as an employee of University of Utah Health. Dr. Clardy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca/Alexion. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/AAN Publications. The institution of Dr. Clardy has received research support from Sumaira Foundation for NMO. The institution of Dr. Clardy has received research support from NIH/NINDS. The institution of Dr. Clardy has received research support from SRNA. The institution of Dr. Clardy has received research support from Alexion/AstraZeneca. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a AAN Summer Meeting CoDirector Travel and Lodging with AAN. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Travel/Lodging/Honoraria with U of Iowa, Miami, Stanford, Barrow, Beaumont Health, CCF, Emory.