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J Child Neurol. 2015 Feb;30(2):238-45. doi: 10.1177/0883073813515947. Epub 2014 Jan 5.

Longitudinal electroencephalographic (EEG) findings in pediatric anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis: the Padua experience.

Author information

1
Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy.
2
Pediatric Neurophysiology Unit, Department of Pediatrics, University of Padua, Italy.
3
Department of Neurology, Ca' Foncello Hospital, Treviso, Italy.
4
Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy Pediatric Neurophysiology Unit, Department of Pediatrics, University of Padua, Italy Lifespan Cognitive Neuroscience Laboratory, Department of General Psychology, University of Padua, Italy.
5
Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy stefano.sartori@unipd.it.

Abstract

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.

KEYWORDS:

EEG; anti-NMDAR encephalitis; children; rhythmic pattern; seizure

PMID:
24396130
DOI:
10.1177/0883073813515947
[Indexed for MEDLINE]

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