The Anti-NMDA Receptor Encephalitis Foundation Newsletter

This is the first study reporting non-HLA susceptibility genes for anti-NMDAR encephalitis. BANK1, IRF7 and TBX21 polymorphisms were associated with anti-NMDAR encephalitis. IRF7 rs1131665 wa

 




SHARE May 12, 2021RESEARCH ARTICLE Clinical, Neuroimmunologic, and CSF Investigations in First Episode Psychosis View ORCID ProfileMar Guasp, Eloi Giné-Servén, Estibaliz Maudes, View ORCID ProfileMireia Rosa-Justicia, Eugenia Martínez-Hernández, Ester Boix-Quintana, Miquel Bioque, Virginia Casado, Yasmina Módena-Ouarzi, Nicolau Guanyabens, Desiree Muriana, Gisela Sugranyes, Isabella Pacchiarotti, Eva Davi-Loscos, Cristina Torres-Rivas, View ORCID ProfileJosé Ríos, Lidia Sabater, Albert Saiz, Francesc Graus, Josefina Castro-Fornieles, Eduard Parellada, View ORCID ProfileJosep Dalmau First published May 12, 2021, DOI: https://doi.org/10.1212/WNL.0000000000012191 FULL PDF CITATION PERMISSIONS MAKE COMMENT SEE COMMENTS Downloads0 Abstract Objectives: To report the neuropsychiatric features and frequency of N-methyl-d-aspartate receptor (NMDAR) and other neuronal IgG antibodies in patients with first episode psychosis (FEP), and assess the performance of reported warning signs and criteria for autoimmune psychosis (AP). Methods: Prospective observational study of patients with FEP assessed for neuropsychiatric symptoms, serum and CSF neuronal antibodies (brain immunohistochemistry, cell-based assays, live neurons), and warning signs and criteria of AP. Previous autoimmune FEP series were reviewed. Findings: 105 patients were included; median age 30 years (range 14-75), 44 (42%) female. None had neuronal antibodies. Two/105 (2%) had CSF pleocytosis, 4/100 (4%) brain MRI abnormalities, and 3/73 (4%) EEG alterations. Thirty-four (32%) and 39 (37%) patients fulfilled two sets of warning signs of AP, and 21 (20%) fulfilled criteria of possible or probable AP, yet none developed AP. The cause of FEP was psychiatric in 101 (96%) and non-psychiatric in 4 (4%). During this study, 3 patients with psychosis caused by anti-NMDAR encephalitis were transferred to our center; 2 did not meet criteria for possible AP. Of 1159 reported FEP patients, only 7 (1%) had CSF studies; 36 (3%) had serum NMDAR-antibodies (without definite diagnosis of AP), and 4 had CSF NMDAR-antibodies (3 classic anti-NMDAR encephalitis and 1 with isolated psychiatric features). Conclusions: NMDAR-antibodies were not found in patients with FEP unless they had anti-NMDAR encephalitis. Warning signs and criteria for AP have limited utility when neurological symptoms are absent or paraclinical tests are normal. A diagnostic algorithm for autoimmune FEP is provided. Received December 2, 2020. Accepted in final form March 26, 2021. © 2021 American Academy of Neurology AAN Members We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page. Google Safari Microsoft Edge Firefox CLICK HERE TO LOGIN AAN Non-Member Subscribers CLICK HERE TO LOGIN Purchase access For assistance, please contact: AAN Members (800) 879-1960 or (612) 928-6000 (International) Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international) Sign Up Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here  Purchase Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed. YOU MAY ALSO BE INTERESTED IN RELATED ARTICLES No related articles found. TOPICS DISCUSSED ALERT ME

 




In recent years, studies have shown higher prevalence of autoantibodies in patients with schizophrenia compared to healthy individuals. This study applies an untargeted and a targeted affinity proteomics approach to explore and characterize the autoantibody repertoire in brain tissues from 73…

 




SIGN IN TO PRACTICEUPDATE Only registered members have full access to PracticeUpdate content. Sign in Not a member? Join for free Additional Info Article Citation Further Reading FEATURED Long-Term Effects of Cholinesterase Inhibitors on Cognitive Decline and Mortality Neurology · May 14, 2021 updated FEATURED Autoantibodies Against Purkinje Cell Protein RGS8 in Paraneoplastic Cerebellar Syndrome Neurol Neuroimmunol Neuroinflamm · May 13, 2021 FEATURED Relationship Between Clinical Characteristics and MRI Results in Ménière Disease Sci Rep · May 11, 2021 STORY OF THE WEEK CSF Findings in Patients With Psychotic Symptoms Sci Rep · May 11, 2021 STORY OF THE WEEK Clinical and Prognostic Value of Immunogenetic Characteristics in Anti-LGI1 Encephalitis Neurol Neuroimmunol Neuroinflamm · May 10, 2021 updated FEATURED Development and Validation of a Tool to Predict Seizure Freedom After Hemispherectomy Epilepsia · May 07, 2021 updated FEATURED Efficacy of Spoken Word Comprehension Therapy in Chronic Aphasia J. Neurol. Neurosurg. Psychiatr. · May 07, 2021 updated FEATURED Partial and Nonresponders to OnabotulinumtoxinA Can Benefit From Anti-CGRP Monoclonal Antibodies Eur. J. Neurol. · May 06, 2021 FEATURED Effect of Lateral Therapy Switches to Oral Moderate-Efficacy Drugs in MS J. Neurol. Neurosurg. Psychiatr. · May 06, 2021 STORY OF THE WEEK Statins After Ischemic Stroke in the Oldest Stroke · May 05, 2021 FEATURED Thrombotic Thrombocytopenia After Ad26.COV2.S Vaccine—Manufacturer’s Response N. Engl. J. Med · May 05, 2021

 




This article on paraneoplastic neurologic disorders provides an update on the diagnostic approach, utility and pitfalls of autoantibody testing and emerging settings in which these disorders are encountered.

 




Here, Harald Prüss discusses how autoantibodies can contribute to neurological diseases. The identification of specific autoantibodies to neuronal and glial targets has increased our understanding of autoimmunity in the central nervous system and led to the reclassification of some diseases…

 




JACC Journals › JACC › Archives › Vol. 77 No. 18_Supplement_1 Previous Next AUTOIMMUNE ENCEPHALITIS IN A PATIENT WITH CONCURRENT PERI-PARTUM CARDIOMYOPATHY (PPCM) Complex Clinical Cases J Am Coll Cardiol. 2021 May, 77 (18_Supplement_1) 2279 Information Copyright © 2021, The Author. Published by Elsevier on Behalf of The American College of Cardiology Foundation. This is an Open Access Article under the CC BY-NC-ND License (http://creativecommons.org/licenses/by-nc-nd/4.0/). Article History Published onlineMay 3, 2021

 




The COVID-19 infectious agent, SARS-CoV-2, has a high affinity for human angiotensin-converting
enzyme 2 (ACE2) receptor. This receptor is also expressed in neurons and glial cells, which could explain the reported neurological manifestations, such as olfactory neuropathy (anosmia), peripheral…

 




We retrospectively reviewed clinical information of pediatric patients whose CSF was analyzed for NMDAR antibodies, and evaluated the 2016 diagnostic criteria for anti-NMDA receptor encephalitis. The criteria showed high sensitivity but low positive predictive value in our cohort.

 




Antibodies directed against the voltage-gated potassium channel complex (anti-VGKCs) are implicated in several autoimmune conditions including limbic encephalitis and epilepsy. However, emerging evidence suggests that only specific subtypes of anti-VGKCs are pathogenic.

 




Background: The immunotherapy that is more effective for seizures caused by viral encephalitis and autoimmune encephalitis and the long-term use of anti-epileptic drugs is not clear. We aimed to compare the immunotherapy and prognosis of seizures caused by viral encephalitis a…

 




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