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

Authors

  • José Fidel Baizabal-Carvallo MD, MSc,

    1. Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
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  • Amber Stocco MD,

    1. Division of Pediatric Neurology and Developmental Neuroscience, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
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  • Eyal Muscal MD,

    1. Division of Pediatric Neurology and Developmental Neuroscience, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
    2. Division of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
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  • Joseph Jankovic MD

    Corresponding author
    • Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
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  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

Correspondence to: Dr. Joseph Jankovic, Professor of Neurology, Distinguished Chair in Movement Disorders, Director, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Department of Neurology, the Smith Tower, Suite 1801, 6550 Fannin, Houston, Texas 77030, USA; josephj@bcm.tmc.edu

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. © 2013 Movement Disorder Society

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