Brain on fire : Anti-N-Methyl D-Aspartate (NMDA) receptor encephalitis in a child / Katrina D. Balangue.

Includes appendices and bibliographical references.

Abstract: Autoimmunine encephalitis occurs as a more common cause of pediatric encephalopathy than previously imagined. This has been challenging to most physicians. Differential diagnoses include infectious and post-infectious processes, systematic inflammatory conditions such as systematic lupus erythematosus, and primary CNS vasculitis. Newly recognized anti-neuronal antibody-mediated inflammatorydisorders such as anti-N-methyl-D-aspartatereceptor (NMDA) receptor encephalitis have become an important diagnostic consideration in children presenting with severe newly acquired neuropsychiatric symptoms. Here, we present a male pediatric patient who initially manifested with seizures disorder. The seizure disorder was eventually accompanied with involuntary movements, described as chorea-like, associated with psychiatric symptoms. Anti-NMDA receptor encephalitis was entertained, and confirmed by presence of antibodies to the NMDA receptors in the CSF. Hence, he was started on methylprednisolone. His symptoms worsened and eventually he was transffered to the intensive care unit. Unfortunately, he expired due to unmanageable autonomic dysfunction. Critical care management of Anti-NMDA receptor encephalitis can be further investigated to help improve treatment strategies.

Research - Department of Child Health