Anti-N-methyl-D-aspartate receptor encephalitis in adults: a systematic review and analysis.

IF 1.1 Q4 PSYCHIATRY

NEUROPSYCHIATRIE Pub Date : 2024-06-01 Epub Date: 2023-08-07 DOI:10.1007/s40211-023-00478-9

Yam R Giri, Allison Parrill, Sreedevi Damodar, Joshua Fogel, Nisrin Ayed, Muhammad Syed, Ijendu Korie, Sivaranjani Ayyanar, Christopher Typhair, Seema Hashmi, Bom B Giri

{"title":"Anti-N-methyl-D-aspartate receptor encephalitis in adults: a systematic review and analysis.","authors":"Yam R Giri, Allison Parrill, Sreedevi Damodar, Joshua Fogel, Nisrin Ayed, Muhammad Syed, Ijendu Korie, Sivaranjani Ayyanar, Christopher Typhair, Seema Hashmi, Bom B Giri","doi":"10.1007/s40211-023-00478-9","DOIUrl":null,"url":null,"abstract":"Purpose: To analyze predictors of treatment outcome for anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in adults.Methods: We performed a comprehensive literature search of PubMed, PsycInfo, and OVID. We included 424 patients from case reports and case series. Demographics, anti-NMDAR antibodies, prodromal and presenting symptoms, diagnostic workup, and treatment variables were recorded. Inferential analyses were performed in the subset (n = 299) of those with known treatment outcomes. Multivariate multinomial logistic regression analysis for treatment outcome compared full recovery versus partial recovery and full recovery versus death.Results: Treatment outcomes consisted of 34.67% full recovery (n = 147), 30.90% partial recovery (n = 131), 4.95% death (n = 21), and 29.48% unknown (n = 125). Speech/language abnormality and abnormal electroencephalogram (EEG) were each significantly associated with a higher relative risk for a full recovery. Treatment with intravenous immunoglobulin and plasmapheresis were each significantly associated with a higher relative risk for partial recovery. The analysis comparing death to full recovery found that catatonia was significantly associated with a lower relative risk for death. Increased age, orofacial dyskinesia, and no tumor removal were each significantly associated with a higher relative risk for death.Conclusion: Increased age, orofacial dyskinesia, and no tumor removal were associated with a higher relative risk for death in anti-NMDAR encephalitis in adults. Clinicians should monitor and appropriately treat anti-NMDAR encephalitis with these findings to minimize the risk of death.","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"NEUROPSYCHIATRIE","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40211-023-00478-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/7 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To analyze predictors of treatment outcome for anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in adults.

Methods: We performed a comprehensive literature search of PubMed, PsycInfo, and OVID. We included 424 patients from case reports and case series. Demographics, anti-NMDAR antibodies, prodromal and presenting symptoms, diagnostic workup, and treatment variables were recorded. Inferential analyses were performed in the subset (n = 299) of those with known treatment outcomes. Multivariate multinomial logistic regression analysis for treatment outcome compared full recovery versus partial recovery and full recovery versus death.

Results: Treatment outcomes consisted of 34.67% full recovery (n = 147), 30.90% partial recovery (n = 131), 4.95% death (n = 21), and 29.48% unknown (n = 125). Speech/language abnormality and abnormal electroencephalogram (EEG) were each significantly associated with a higher relative risk for a full recovery. Treatment with intravenous immunoglobulin and plasmapheresis were each significantly associated with a higher relative risk for partial recovery. The analysis comparing death to full recovery found that catatonia was significantly associated with a lower relative risk for death. Increased age, orofacial dyskinesia, and no tumor removal were each significantly associated with a higher relative risk for death.

Conclusion: Increased age, orofacial dyskinesia, and no tumor removal were associated with a higher relative risk for death in anti-NMDAR encephalitis in adults. Clinicians should monitor and appropriately treat anti-NMDAR encephalitis with these findings to minimize the risk of death.

查看原文本刊更多论文

成人抗N-甲基-D-天冬氨酸受体脑炎：系统回顾与分析。

目的：分析成人抗 N-甲基-D-天冬氨酸受体（NMDAR）脑炎治疗效果的预测因素：我们对 PubMed、PsycInfo 和 OVID 进行了全面的文献检索。我们从病例报告和系列病例中纳入了 424 例患者。我们记录了人口统计学、抗 NMDAR 抗体、前驱症状和主要症状、诊断工作和治疗变量。对已知治疗结果的患者子集（n = 299）进行了推理分析。治疗结果的多变量多项式逻辑回归分析比较了完全康复与部分康复、完全康复与死亡：治疗结果包括 34.67% 完全康复（n = 147）、30.90% 部分康复（n = 131）、4.95% 死亡（n = 21）和 29.48% 不详（n = 125）。言语/语言异常和脑电图（EEG）异常与完全康复的相对风险较高明显相关。静脉注射免疫球蛋白和血浆置换治疗与部分痊愈的相对风险较高明显相关。对死亡和完全康复进行比较分析后发现，紧张性精神障碍与较低的死亡相对风险明显相关。年龄增大、口面部运动障碍和未切除肿瘤均与较高的死亡相对风险显著相关：结论：年龄增大、口面部运动障碍和未切除肿瘤与成人抗 NMDAR 脑炎患者较高的死亡相对风险有关。临床医生应根据上述结果监测并适当治疗抗 NMDAR 脑炎，以最大限度地降低死亡风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

NEUROPSYCHIATRIE PSYCHIATRY-

CiteScore

3.80

自引率

20.00%

发文量

期刊介绍： Die Zeitschrift ist das offizielle Organ der „Österreichischen Gesellschaft für Psychiatrie, Psychotherapie und Psychosomatik (ÖGPP)'', und wissenschaftliches Organ der Österreichischen Alzheimer Gesellschaft, der Österreichischen Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, der Österreichischen Schizophreniegesellschaft, und der pro mente austria - Österreichischer Dachverband der Vereine und Gesellschaften für psychische und soziale Gesundheit.Sie veröffentlicht Übersichten zu relevanten Themen des Fachs, Originalarbeiten, Kasuistiken sowie Briefe an die Herausgeber. Zudem wird auch Buchbesprechungen sowie Neuigkeiten aus den Bereichen Personalia, Standes- und Berufspolitik sowie Kongressankündigungen Raum gewidmet.Thematisch ist das Fach Psychiatrie und die Methoden der Psychotherapie in allen ihren Facetten vertreten. Die Zeitschrift richtet sich somit an alle Berufsgruppen, die sich mit Ursachen, Erscheinungsformen und Behandlungsmöglichkeiten von psychischen Störungen beschäftigen. -----------------------------------------------------------------------------------------------------· The professional and educational journal of the Austrian Society of Psychiatry, Psychotherapy and Psychosomatics (Österreichische Gesellschaft für Psychiatrie, Psychotherapie und Psychosomatik; ÖGPP) and the Austrian Society of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (Österreichische Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie; ÖGKJP)· Overviews of all relevant topics pertaining to the discipline· Intended for all occupational groups committed to the causes and manifestations of, as well as therapy options for psychic disorders· All manuscripts principally pass through a double-blind peer review process involving at least two independent expertsThe official journal of the Austrian Societies of Psychiatry, Psychotherapy and Psychosomatics (ÖGPP) and Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (ÖGKJP)The journal publishes overviews of relevant issues in the field, original work, case reports and letters to the editors. In addition, space is devoted to book reviews, news from the areas of personnel matters and professional policies, and conference announcements.Thematically, the discipline of psychiatry and the methods of psychotherapy are represented in all their facets. The journal is thus aimed at all professional groups committed to the causes and manifestations of, as well as therapy options for psychic disorders