Anti-N-Methyl-D-Aspartate Receptor Encephalitis in a 3-Year-Old Toddler with the Involvement of Severe Autonomic Dysfunctions in Gastrointestinal System: A Case Report
04 August 2017
04 December 2017
23 January 2018 (online)
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is under-recognized in children and adults. It is characterized by prominent neurologic and psychiatric features at first onset. Autonomic manifestations are rarer in children than in adults. We report a 3-year-old male patient with rare manifestation of severe autonomic dysfunctions of the gastrointestinal system and atypical prodromal symptoms. The serum and CSF of the patient were positive for anti-NMDA receptor antibodies, and his electroencephalogram results showed an “extreme delta brush” pattern. The patient had completely recovered by the sixth-month assessment after receiving first-line immunomodulatory treatment. Thus, anti-NMDAR encephalitis should be considered in the differential diagnosis of children with mental status changes and widespread autonomic dysfunction, particularly if symptoms are accompanied by gastrointestinal dysmotility and anhidrosis.
Keywordschild - anti-N-methyl-D-aspartate receptor - encephalitis - autonomic nervous system disease - immunotherapy
This study was funded by the National Key Research Program of China (No. 2016YC1000700) and the National Nature Fund (No. 81471329).
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