Variations of movement disorders in anti-N-methyl-D-aspartate receptor encephalitis A nationwide study in Taiwan

Bi Chun Duan, Wen Chin Weng, Kuang Lin Lin, Lee Chin Wong, Sung Tse Li, Mei Hsin Hsu, Jainn Jim Lin, Pi Chaun Fan, Ming I. Lin, Nan Chang Chiu, Yu Ching Lin, Huei Shyong Wang, Kun Long Hung, Wang Tso Lee

研究成果: Article

17 引文 (Scopus)

摘要

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is one of the most common autoimmune encephalitis that presents with a wide variety of movement disorders. The purpose of our study is to review the manifestations and duration of movement disorders in different ages with NMDAR encephalitis. A retrospective cohort of 28 patients (20 females and 8 males) with positive cerebrospinal fluid (CSF) anti-NMDAR antibody in a 5-year period from major hospitals in Taiwan was enrolled. They were categorized into 3 age groups: 7 patients were ≤10 years, 14 patients were 10 to 18 years, and 7 patients were >18 years. Total 28 patients (20 females and 8 males) with age ranging from 8 months to 38 years were enrolled. Nearly all patients (n=27/28, 96%) presented with at least 2 types of disorders, including orofacial-lingual dyskinesia (OFLD; n=20), catatonia (n=19), tremor (n= 11), bradykinesia (n=11), dystonia (n=11), choreoathethosis (n=9), and ballism (n=3). Only 1 patient below 10 years presented with isolated periodic choreoathethosis without other movement disorders. OFLD was common in all age groups. Choreoathetosis was most common in patients aged ≤10 years, while catatonia was most common in patients aged >10 years (P=0.001 and 0.020, respectively). Bradykinesia was also more common in patients aged >10 years (P=0.020). The clinical presentations of movement disorders were not significantly different in the age of 10 to 18 years and those >18 years. Neither patient ≤10 years old nor male patients had associated tumors. All patients' movement disorders were improved after treatment, while female patients with tumors had worse short-term outcome (P=0.014). Compared with other disorders, choreoathetosis persisted significantly longer in patients ≤10 years (P=0.038), while OFLD and catatonia last longer in patients >10 years (P=0.047 and 0.002, respectively). Our study shows that hyperkinetic movements such as choreoathetosis are more common and last longer in younger age groups, whereas hypokinetic movements such as catatonia and bradykinesia are more common and last longer in older age groups. Female patients with ovarian tumors had worse short-term outcome.

原文English
文章編號e4365
期刊Medicine (United States)
95
發行號37
DOIs
出版狀態Published - 2016 一月 1

指紋

Anti-N-Methyl-D-Aspartate Receptor Encephalitis
Movement Disorders
Taiwan
Catatonia
Hypokinesia
Age Groups
N-Methyl-D-Aspartate Receptors

All Science Journal Classification (ASJC) codes

  • Medicine(all)

引用此文

Duan, Bi Chun ; Weng, Wen Chin ; Lin, Kuang Lin ; Wong, Lee Chin ; Li, Sung Tse ; Hsu, Mei Hsin ; Lin, Jainn Jim ; Fan, Pi Chaun ; Lin, Ming I. ; Chiu, Nan Chang ; Lin, Yu Ching ; Wang, Huei Shyong ; Hung, Kun Long ; Lee, Wang Tso. / Variations of movement disorders in anti-N-methyl-D-aspartate receptor encephalitis A nationwide study in Taiwan. 於: Medicine (United States). 2016 ; 卷 95, 編號 37.
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abstract = "Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is one of the most common autoimmune encephalitis that presents with a wide variety of movement disorders. The purpose of our study is to review the manifestations and duration of movement disorders in different ages with NMDAR encephalitis. A retrospective cohort of 28 patients (20 females and 8 males) with positive cerebrospinal fluid (CSF) anti-NMDAR antibody in a 5-year period from major hospitals in Taiwan was enrolled. They were categorized into 3 age groups: 7 patients were ≤10 years, 14 patients were 10 to 18 years, and 7 patients were >18 years. Total 28 patients (20 females and 8 males) with age ranging from 8 months to 38 years were enrolled. Nearly all patients (n=27/28, 96{\%}) presented with at least 2 types of disorders, including orofacial-lingual dyskinesia (OFLD; n=20), catatonia (n=19), tremor (n= 11), bradykinesia (n=11), dystonia (n=11), choreoathethosis (n=9), and ballism (n=3). Only 1 patient below 10 years presented with isolated periodic choreoathethosis without other movement disorders. OFLD was common in all age groups. Choreoathetosis was most common in patients aged ≤10 years, while catatonia was most common in patients aged >10 years (P=0.001 and 0.020, respectively). Bradykinesia was also more common in patients aged >10 years (P=0.020). The clinical presentations of movement disorders were not significantly different in the age of 10 to 18 years and those >18 years. Neither patient ≤10 years old nor male patients had associated tumors. All patients' movement disorders were improved after treatment, while female patients with tumors had worse short-term outcome (P=0.014). Compared with other disorders, choreoathetosis persisted significantly longer in patients ≤10 years (P=0.038), while OFLD and catatonia last longer in patients >10 years (P=0.047 and 0.002, respectively). Our study shows that hyperkinetic movements such as choreoathetosis are more common and last longer in younger age groups, whereas hypokinetic movements such as catatonia and bradykinesia are more common and last longer in older age groups. Female patients with ovarian tumors had worse short-term outcome.",
author = "Duan, {Bi Chun} and Weng, {Wen Chin} and Lin, {Kuang Lin} and Wong, {Lee Chin} and Li, {Sung Tse} and Hsu, {Mei Hsin} and Lin, {Jainn Jim} and Fan, {Pi Chaun} and Lin, {Ming I.} and Chiu, {Nan Chang} and Lin, {Yu Ching} and Wang, {Huei Shyong} and Hung, {Kun Long} and Lee, {Wang Tso}",
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doi = "10.1097/MD.0000000000004365",
language = "English",
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journal = "Medicine (United States)",
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Duan, BC, Weng, WC, Lin, KL, Wong, LC, Li, ST, Hsu, MH, Lin, JJ, Fan, PC, Lin, MI, Chiu, NC, Lin, YC, Wang, HS, Hung, KL & Lee, WT 2016, 'Variations of movement disorders in anti-N-methyl-D-aspartate receptor encephalitis A nationwide study in Taiwan', Medicine (United States), 卷 95, 編號 37, e4365. https://doi.org/10.1097/MD.0000000000004365

Variations of movement disorders in anti-N-methyl-D-aspartate receptor encephalitis A nationwide study in Taiwan. / Duan, Bi Chun; Weng, Wen Chin; Lin, Kuang Lin; Wong, Lee Chin; Li, Sung Tse; Hsu, Mei Hsin; Lin, Jainn Jim; Fan, Pi Chaun; Lin, Ming I.; Chiu, Nan Chang; Lin, Yu Ching; Wang, Huei Shyong; Hung, Kun Long; Lee, Wang Tso.

於: Medicine (United States), 卷 95, 編號 37, e4365, 01.01.2016.

研究成果: Article

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AU - Weng, Wen Chin

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AU - Li, Sung Tse

AU - Hsu, Mei Hsin

AU - Lin, Jainn Jim

AU - Fan, Pi Chaun

AU - Lin, Ming I.

AU - Chiu, Nan Chang

AU - Lin, Yu Ching

AU - Wang, Huei Shyong

AU - Hung, Kun Long

AU - Lee, Wang Tso

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AB - Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is one of the most common autoimmune encephalitis that presents with a wide variety of movement disorders. The purpose of our study is to review the manifestations and duration of movement disorders in different ages with NMDAR encephalitis. A retrospective cohort of 28 patients (20 females and 8 males) with positive cerebrospinal fluid (CSF) anti-NMDAR antibody in a 5-year period from major hospitals in Taiwan was enrolled. They were categorized into 3 age groups: 7 patients were ≤10 years, 14 patients were 10 to 18 years, and 7 patients were >18 years. Total 28 patients (20 females and 8 males) with age ranging from 8 months to 38 years were enrolled. Nearly all patients (n=27/28, 96%) presented with at least 2 types of disorders, including orofacial-lingual dyskinesia (OFLD; n=20), catatonia (n=19), tremor (n= 11), bradykinesia (n=11), dystonia (n=11), choreoathethosis (n=9), and ballism (n=3). Only 1 patient below 10 years presented with isolated periodic choreoathethosis without other movement disorders. OFLD was common in all age groups. Choreoathetosis was most common in patients aged ≤10 years, while catatonia was most common in patients aged >10 years (P=0.001 and 0.020, respectively). Bradykinesia was also more common in patients aged >10 years (P=0.020). The clinical presentations of movement disorders were not significantly different in the age of 10 to 18 years and those >18 years. Neither patient ≤10 years old nor male patients had associated tumors. All patients' movement disorders were improved after treatment, while female patients with tumors had worse short-term outcome (P=0.014). Compared with other disorders, choreoathetosis persisted significantly longer in patients ≤10 years (P=0.038), while OFLD and catatonia last longer in patients >10 years (P=0.047 and 0.002, respectively). Our study shows that hyperkinetic movements such as choreoathetosis are more common and last longer in younger age groups, whereas hypokinetic movements such as catatonia and bradykinesia are more common and last longer in older age groups. Female patients with ovarian tumors had worse short-term outcome.

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