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Dev Med Child Neurol. 2016 Oct;58(10):1092-4. doi: 10.1111/dmcn.13169. Epub 2016 Jun 3.

N-methyl-d-aspartate (NMDA) receptor antibodies encephalitis mimicking an autistic regression.

Author information

1
Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
2
Paediatric Neuroscience, Evelina Children's Hospital @ Guys and St Thomas' NHS Foundation Trust, Kings Health Partners Academic Health Science Centre, London, UK.
3
Department of Paediatric Neurology, Birmingham Children's Hospital, Birmingham, UK.

Abstract

Expressive dysphasia and mutism are common clinical features in children and adults with N-methyl-d-aspartate receptor antibodies (NMDAR-Ab) encephalitis, and are likely to result from NMDAR hypofunction. A prodromal loss of social and communication skills can typify that of an autistic regression, particularly when presenting under the age of 3 years. Here we describe two toddlers who presented with developmental regression, particularly of their social communication skills, mimicking an autistic regression, who were found to have NMDAR-Ab in the serum and cerebrospinal fluid. Although both patients had some other neurological features, they were subtle, which resulted in delayed diagnosis of NMDAR-Ab encephalitis. Importantly, immunotherapy was beneficial in both patients, with significant improvement of their language skills and behaviour.

PMID:
27255282
DOI:
10.1111/dmcn.13169
[Indexed for MEDLINE]
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