4. Đặc điểm lâm sàng, cận lâm sàng viêm não kháng thụ thể n-methyl-d-aspartate ở trẻ em tại Bệnh viện Nhi Trung ương

Abstract

Anti-N-methy-D-aspartate receptor encephalitis is one of the most common autoimmune encephalitis. This study described the clinical characteristics of 41 cases treated at the National Children's Hospital between January 2021 and May 2022. The majority (61%) of patients had unknown etiology; 7.3% were paraneoplastic; and 31.7% had post-infectious anti-NMDA receptor encephalitis. The median age was 4.9 (range: 0.6 - 14.5), and the male/female ratio was 0.95. The most common clinical manifestations were psychosis (63.4%), seizure (61%), fever (53.7%), and sleep disturbances (51.2%). EEG abnormalities were found in 72% of the patients, cerebrospinal fluid changes in 70.7% of patients with slight increase in cell count: 12 (0 - 410), normal protein: 0.31 ± 0.14, lesions on cranial magnetic resonance in 48.6%. Most (82.8%) of patients received first-line immunotherapy, 7.3% received second-line therapy, and 9.8% of patients maintained immunotherapy after second-line therapy. On average, after treatment, the modified Rankin score was reduced by 0.76 points. The median duration of hospitalization was 22 (range: 5-79) days.