Clinical Analysis Of Anti-N-Methyl-D-Aspartate Receptor Encephalitis In Adults And Children

Objective: The clinical data of anti-N-methyl-D-aspartate(NMDA)receptor encephalitis was analyzed in adults and children.Methods:60 patients diagnosed with anti-NMDA receptor encephalitis were retrospectively collected and divided into the adult group(>14 years)and the child group(?14 years).The clinical performance,auxiliary examination,treatment and prognosis of the two groups were compared.Results:There were 38 cases in the adult group and 22 cases in the child group.A total of 33(55%)patients had prodromal symptoms,and 18 adults and 4 children had prodromal fever symptoms(P=0.029).The main clinical manifestations of patients in the two groups were abnormal behaviour,seizures,or status epilepticus.Seizures were present in 30 adults and 11 children(P=0.020),status epilepticus were present in 1 adult and 5 children(P=0.021),and headache in 20 adults and 3 children(P=0.003).6 adults had ovarian teratoma.16 adults and 3 children had pulmonary infections(P=0.022),and children were more likely to be infected with pathogens such as mycoplasma and EB virus(P=0.000).Patients in both groups received first-line treatment,with 6(16%)adults and 2(9%)children receiving second-line treatment.Four adults and one child received intrathecal injection.Thirty-two adults and 17 children were followed up.28 adults and 15 children had m RS scores of “good”;the clinical efficacy of both groups was 94%.Conclusions: Prodromal symptoms are present in half of patients,and adults are more likely to develop prodromal symptoms of fever than children.Adults are more susceptible to seizures,headaches,and lung infections than children,and children are more likely to have persistent status epilepticus and concomitant pathogen infections.Most patients in both groups have a good prognosis.Intrathecal injection may have a certain clinical effect in severely refractory patients who are not satisfied with first-line treatment.