Acute limbic encephalitis and NMDA type-glutamate receptor

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  • Takahashi Yukitoshi
    National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders Department of Pediatrics, Gifu University School of Medicine
  • Yamazaki Etsuko
    National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders
  • Nishimura Shigeko
    National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders
  • Tsunogae Hisano
    National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders
  • Niwa Kenji
    Department of Obstetricus, Gifu University School of Medicine
  • Dalmau Josep
    Department of Neurology, University of Pennsylvania
  • Imai Katsumi
    National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders
  • Fujiwara Tateki
    National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders

Bibliographic Information

Other Title
  • シンポジウム３‐４　抗ＮＭＤＡ受容体抗体陽性脳症　急性辺縁系脳炎・脳症とＮＭＤＡ型グルタミン酸受容体
  • 急性辺縁系脳炎・脳症とNMDA型グルタミン酸受容体
  • キュウセイ ヘンエンケイ ノウエン ノウショウ ト NMDAガタ グルタミンサン ジュヨウタイ

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Abstract

We compared clinical characteristics and autoantibodies against GluRε2 between 95 patients with non-paraneoplastic non-herpetic acute limbic encephalitis (NPNHALE) and 19 patients with non-herpetic acute encephalitis accompanying ovarian teratoma (NHAE-OT).<br> Onset age (mean±SD) was 27.7±18.6 years old in NPNHALE, 27.5±6.5 in NHALE-OT. Preceding factors were found in 63.8% of patients with NPNHALE and 89.5% of patients with NHALE-OT (Fisher's exact test, p=0.025), and major preceding factors were upper respiratory infections or fever in both groups. Symptoms at the onset were disorder of behavior and talk > seizures > impairment of consciousness in NPNHALE, and disorder of behavior and talk > seizures > disorientation in NHALE-OT. Symptoms at the acute stage were similar between NPNHALE and NHAE-OT, but duration of hospital stay was longer in NHAE-OT (209.0 days) than NPNHALE (87.5 days)(Mann Whitney test, p<0.0001). At the onset, cell counts in CSF were 51.6±66.4/mm3 and protein levels were 35.4±14.7mg/dl, and IgG levels were 6.6±4.2mg/dl in NHAE-OT, and these data were not significantly different between NPNHALE and NHAE-OT.<br> In acute stage, autoantibodies against whole molecule of GluRε2 in CSF were detected in 51.8% (29/56) of adult NPNHALE, and 40% (6/15) of NHAE-OT patients by immunoblot. These autoantibodies in both groups included epitopes to n-terminal of GluRε2. Antibodies against NMDAR complex (Dalmau's method) in CSF were detected in 90.9% (10/11) of NHAE-OT patients.<br>

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 48 (11), 926-929, 2008

    Societas Neurologica Japonica

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