The spectrum of movement disorders in children with anti-NMDA receptor encephalitis

Mov Disord. 2013 Apr;28(4):543-7. doi: 10.1002/mds.25354. Epub 2013 Feb 11.

Abstract

Background: Movement disorders are frequent but difficult to characterize in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

Methods: The phenomenology of movement disorders was characterized after a detailed examination of children with anti-NMDAR-encephalitis.

Results: We studied 9 children (5 females), ages 3-14 years, with confirmed anti-NMDAR-encephalitis. All patients presented with at least 1 movement disorder, including chorea (n=4), stereotypic movements (n=4), ataxia (n=3), limb dystonia (n=2), limb myorhythmia (n=2), oromandibular dystonia (n=2), facial myorhythmia, blepharospasm, opisthotonus, athetosis, and tremor (n=1, each). More than a single movement disorder was observed in 6 of these patients. Resolution of the abnormal movements was observed in all patients with immunotherapy; 1 patient improved with tetrabenazine.

Conclusions: A wide variety of movement disorders, often in combination, can be observed in children with anti-NMDAR encephalitis. Patients commonly present with more than a single movement disorder.

MeSH terms

  • Adolescent
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / physiopathology*
  • Child
  • Child, Preschool
  • Dyskinesias / physiopathology*
  • Female
  • Humans
  • Immunotherapy / methods
  • Male
  • Movement Disorders / complications
  • Movement Disorders / diagnosis
  • Movement Disorders / physiopathology*
  • Receptors, N-Methyl-D-Aspartate / metabolism*
  • Tremor / physiopathology

Substances

  • Receptors, N-Methyl-D-Aspartate