ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG BỆNH VIÊM NÃO KHÁNG THỤ THỂ NMDA Ở TRẺ EM

Abstract

Objective: To report the clinical and paraclinical features of 61 pediatric patients with anti N-Methyl -D-Aspartate receptor encephalitis. Study design: cross sectional study, review of clinical data all patients with anti NMDA receptor encephalitis who did not have past medical history of viral encephalitis from January 2019 to August 2021 in National Children hospital. Results: The median age of patient was 7 ±3,7 years, 25 males and 36 females; 50,8% patients had prodromal symptoms at 1-2 weeks before onset disease. The most common initial symptom was neurologic, usually seizures. On admission, 93,4% patients presented with behavioral change, frequent  agitation, screaming, 68,9% with mood disorders, 75,4% with sleep disorders; 52,5 % with movement disorders; In 61 patients, 77% patients decreased level of consciousness, only 17% mental status changed in first 3 day onset of the disease ; 2 females had ovarian teratoma; 93,5% patients had abnormal background activity on EEG such as focal slowing or generalized slowing, 23,9% patients had epileptic discharges; 24,6% patients had abnormal brain MRI, 70% patients increased protein level or pleocytosis in cerebral spinal fluid. Conclusion: Anti-NMDA receptor encephalitis in children has diverse clinical symptoms, seizues are common initial symptoms, prominently behavioral-mood disorders, sleep disturbances, speech disorders, mental status impairment and movement disorders. The most common paraclinical changes are EEG with slowing activities, abnormal cerebral spinal fluid and ¼ of cases with abnormal brain MRI