Late-onset anti-NMDA receptor encephalitis.


OBJECTIVE:To describe the clinical features and outcome of anti-NMDA receptor (NMDAR) encephalitis in patients ≥45 years old. METHOD:Observational cohort study. RESULTS:In a cohort of 661 patients with anti-NMDAR encephalitis, we identified 31 patients ≥45 years old. Compared with younger adults (18-44 years), older patients were more often male (45% vs. 12%, p < 0.0001), had lower frequency of tumors (23% vs. 51%, p = 0.002; rarely teratomas), had longer median time to diagnosis (8 vs 4 weeks, p = 0.009) and treatment (7 vs. 4 weeks, p = 0.039), and had less favorable outcome (modified Rankin Scale score 0-2 at 2 years, 60% vs. 80%, p < 0.026). In multivariable analysis, younger age (odds ratio [OR] 0.15, confidence interval [CI] 0.05-0.39, p = 0.0001), early treatment (OR 0.60, CI 0.47-0.78, p < 0.0001), no need for intensive care (OR 0.09, CI 0.04-0.22, p < 0.0001), and longer follow-up (p < 0.0001) were associated with good outcome. Rituximab and cyclophosphamide were effective when first-line immunotherapies failed (OR 2.93, CI 1.10-7.76, p = 0.031). Overall, 60% of patients older than 45 years had full or substantial recovery at 24 months follow-up. CONCLUSIONS:Anti-NMDAR encephalitis is less severe in patients ≥45 years old than in young adults, but the outcome is poorer in older patients. In this age group, delays in diagnosis and treatment are more frequent than in younger patients. The frequency of underlying tumors is low, but if present they are usually carcinomas instead of teratomas in younger patients. Early and aggressive immunotherapy will likely improve the clinical outcome.






Titulaer MJ,McCracken L,Gabilondo I,Iizuka T,Kawachi I,Bataller L,Torrents A,Rosenfeld MR,Balice-Gordon R,Graus F,Dalmau J




Has Abstract


2013-09-17 00:00:00














  • Imitation synkinesia and sensory control of movement.

    abstract::Immitation synkinesia is usually associated with thalamic or parietal lesions. Analysis of three cases shows that the lesions may affect the posterior columns of the spinal cord or even the peripheral nervous system. In our cases, two facts stand out, a large measure of integrity of motor activity and predominant dist...


    pub_type: 杂志文章


    authors: Cambier J,Dehen H

    更新日期:1977-07-01 00:00:00

  • Cortical superficial siderosis progression in cerebral amyloid angiopathy: Prospective MRI study.

    abstract:OBJECTIVE:To investigate the prevalence, predictors, and clinical relevance of cortical superficial siderosis (cSS) progression in cerebral amyloid angiopathy (CAA). METHODS:Consecutive patients with symptomatic CAA meeting Boston criteria in a prospective cohort underwent baseline and follow-up MRI within 1 year. cSS...


    pub_type: 杂志文章


    authors: Pongpitakmetha T,Fotiadis P,Pasi M,Boulouis G,Xiong L,Warren AD,Schwab KM,Rosand J,Gurol ME,Greenberg SM,Viswanathan A,Charidimou A

    更新日期:2020-04-28 00:00:00

  • Practical approaches to incidental findings in brain imaging research.

    abstract::A decade of empirical work in brain imaging, genomics, and other areas of research has yielded new knowledge about the frequency of incidental findings, investigator responsibility, and risks and benefits of disclosure. Straightforward guidance for handling such findings of possible clinical significance, however, has...


    pub_type: 杂志文章,评审


    authors: Illes J,Kirschen MP,Edwards E,Bandettini P,Cho MK,Ford PJ,Glover GH,Kulynych J,Macklin R,Michael DB,Wolf SM,Grabowski T,Seto B

    更新日期:2008-01-29 00:00:00

  • Somatosensory system integrity explains differences in treatment response after stroke.

    abstract:OBJECTIVE:To test the hypothesis that, in the context of robotic therapy designed to enhance proprioceptive feedback via a Hebbian model, integrity of both somatosensory and motor systems would be important in understanding interparticipant differences in treatment-related motor gains. METHODS:In 30 patients with chro...


    pub_type: 临床试验,杂志文章


    authors: Ingemanson ML,Rowe JR,Chan V,Wolbrecht ET,Reinkensmeyer DJ,Cramer SC

    更新日期:2019-03-05 00:00:00

  • A randomized trial of 3,4-diaminopyridine in Lambert-Eaton myasthenic syndrome.

    abstract:OBJECTIVES:The authors report the results of a prospective, placebo-controlled, randomized study to evaluate the effectiveness of 3,4-diaminopyridine (DAP) in patients with Lambert-Eaton myasthenic syndrome (LEMS) and to determine the acute and long-term side effects of DAP. METHODS:Twenty-six patients with LEMS compl...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Sanders DB,Massey JM,Sanders LL,Edwards LJ

    更新日期:2000-02-08 00:00:00

  • Pharmacology of dopamine agonists in the treatment of Parkinson's disease.

    abstract::There is now increasing use of dopamine agonists as effective early monotherapy in the treatment of Parkinson's disease (PD). Dopamine agonists can induce an antiparkinsonian effect through actions on either D(1)-like or D(2)-like dopamine receptors, and the multiple receptor subtypes present in the brain may provide ...


    pub_type: 杂志文章,评审


    authors: Jenner P

    更新日期:2002-02-26 00:00:00

  • MEG localization of language-specific cortex utilizing MR-FOCUSS.

    abstract:OBJECTIVE:To demonstrate noninvasive localization of cognitive cortical areas involved in language processing with magnetoencephalography (MEG) interpreted by multiresolution FOCUSS (MR-FOCUSS), a current density imaging technique. METHOD:MEG data were collected during verb-generation and picture-naming tasks from 18 ...


    pub_type: 杂志文章


    authors: Bowyer SM,Moran JE,Mason KM,Constantinou JE,Smith BJ,Barkley GL,Tepley N

    更新日期:2004-06-22 00:00:00

  • Hepatitis C augments cognitive deficits associated with HIV infection and methamphetamine.

    abstract:OBJECTIVE:To examine the contribution of hepatitis C virus (HCV) infection to neurocognitive dysfunction in individuals with comorbid HIV infection or methamphetamine (METH) dependence. METHODS:Neurocognitive functioning was examined in 430 study participants who were either normal controls or had HCV infection, HIV i...


    pub_type: 杂志文章


    authors: Cherner M,Letendre S,Heaton RK,Durelle J,Marquie-Beck J,Gragg B,Grant I,HIV Neurobehavioral Research Center Group.

    更新日期:2005-04-26 00:00:00

  • Nerve ultrasound improves detection of treatment-responsive chronic inflammatory neuropathies.

    abstract:OBJECTIVE:To examine the diagnostic accuracy of nerve ultrasound in a prospective cohort of consecutive patients with a clinical suspicion of chronic inflammatory neuropathies, including chronic inflammatory demyelinating polyneuropathy, Lewis-Sumner syndrome, and multifocal motor neuropathy, and to determine the added...


    pub_type: 杂志文章


    authors: Herraets IJT,Goedee HS,Telleman JA,van Eijk RPA,van Asseldonk JT,Visser LH,van den Berg LH,van der Pol WL

    更新日期:2020-04-07 00:00:00

  • Lesion of thalamic centromedian--parafascicular complex after chronic deep brain stimulation.

    abstract::A patient with PD who exhibited disabling tremor and prominent dyskinesia underwent deep brain stimulation (DBS) of the left thalamic ventral intermediate nucleus. The electrode migrated and was replaced but with suboptimal clinical response. Two years later, postmortem analysis found the second electrode tip had ente...


    pub_type: 杂志文章


    authors: Henderson JM,O'Sullivan DJ,Pell M,Fung VS,Hely MA,Morris JG,Halliday GM

    更新日期:2001-06-12 00:00:00

  • Methylphenidate, cognition, and epilepsy: A double-blind, placebo-controlled, single-dose study.

    abstract:OBJECTIVE:To evaluate the potential efficacy of immediate-release methylphenidate (MPH) for treating cognitive deficits in epilepsy. METHODS:This was a double-blind, randomized, single-dose, 3-period crossover study in patients with epilepsy and chronic cognitive complaints comparing the effects of placebo and MPH 10 ...


    pub_type: 杂志文章,随机对照试验


    authors: Adams J,Alipio-Jocson V,Inoyama K,Bartlett V,Sandhu S,Oso J,Barry JJ,Loring DW,Meador K

    更新日期:2017-01-31 00:00:00

  • Plasma multianalyte profiling in mild cognitive impairment and Alzheimer disease.

    abstract:OBJECTIVES:While plasma biomarkers have been proposed to aid in the clinical diagnosis of Alzheimer disease (AD), few biomarkers have been validated in independent patient cohorts. Here we aim to determine plasma biomarkers associated with AD in 2 independent cohorts and validate the findings in the multicenter Alzheim...


    pub_type: 杂志文章,多中心研究


    authors: Hu WT,Holtzman DM,Fagan AM,Shaw LM,Perrin R,Arnold SE,Grossman M,Xiong C,Craig-Schapiro R,Clark CM,Pickering E,Kuhn M,Chen Y,Van Deerlin VM,McCluskey L,Elman L,Karlawish J,Chen-Plotkin A,Hurtig HI,Siderowf A,Swens

    更新日期:2012-08-28 00:00:00

  • Fatigue therapy in multiple sclerosis: results of a double-blind, randomized, parallel trial of amantadine, pemoline, and placebo.

    abstract:OBJECTIVE:To determine the relative efficacy of amantadine, pemoline, and placebo in treatment of multiple sclerosis (MS)-related fatigue. BACKGROUND:Fatigue is a complication of MS. Both pemoline and amantadine have been used to treat MS fatigue, but their relative efficacy is not known. METHODS:Amantadine, pemoline...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Krupp LB,Coyle PK,Doscher C,Miller A,Cross AH,Jandorf L,Halper J,Johnson B,Morgante L,Grimson R

    更新日期:1995-11-01 00:00:00

  • Congenital retardation and central motor defect with later evolution of seizure disorder, orofacial dysplasia, and amyotrophy. A clinicopathologic report.

    abstract::Retarded mental and motor development was observed during the first year of life of a full-term female who had been delivered with difficulty. Generalized psychomotor seizures and dysplastic "acromegalic" facial changes began to develop when she was 8 years old, and generalized amyotrophy developed over the next sever...


    pub_type: 杂志文章


    authors: Landau WM,Torack RM,Guggenheim MA

    更新日期:1976-09-01 00:00:00

  • 18F-FDG-PET correlates of cognitive impairment in ALS.

    abstract:OBJECTIVE:To identify the metabolic signature of the various levels of cognitive deficits in amyotrophic lateral sclerosis (ALS) using 18F-2-fluoro-2-deoxy-d-glucose-PET (18F-FDG-PET). METHODS:A total of 170 ALS cases consecutively enrolled at the ALS Center of Turin underwent brain 18F-FDG-PET and were classified as ...


    pub_type: 杂志文章


    authors: Canosa A,Pagani M,Cistaro A,Montuschi A,Iazzolino B,Fania P,Cammarosano S,Ilardi A,Moglia C,Calvo A,Chiò A

    更新日期:2016-01-05 00:00:00

  • Circadian sneezing.

    abstract::Prompted by the observation that a fellow medical student sneezed at about the same time in class every morning, we recorded the time of each of the 118 sneezes she made on 69 days over a 6.5-month period. Analysis of the sneeze times with the goodness-of-fit test revealed a highly nonuniform distribution (p < 0.0001)...


    pub_type: 杂志文章


    authors: Grant AC,Roter EP

    更新日期:1994-03-01 00:00:00

  • Multiple sclerosis among utility workers.

    abstract::The incidence of MS was assessed in a nationwide cohort study of 31,990 employees of Danish utility companies between 1900 and 1993. Overall, 32 cases of MS were diagnosed, as compared with 23.7 expected from national incidence rates, to yield a standardized incidence ratio of 1.35 (95% confidence interval, 0.92 to 1....


    pub_type: 杂志文章


    authors: Johansen C,Koch-Henriksen N,Rasmussen S,Olsen JH

    更新日期:1999-04-12 00:00:00

  • Neutralizing antibodies to interferon beta: assessment of their clinical and radiographic impact: an evidence report: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.

    abstract::The clinical and radiologic impact of developing neutralizing antibodies (NAbs) to interferon beta (IFNbeta) while on this therapy for multiple sclerosis (MS) is assessed. On the basis of Class II and III evidence, it is concluded that treatment of patients with MS with IFNbeta (Avonex, Betaseron, or Rebif) is associa...




    authors: Goodin DS,Frohman EM,Hurwitz B,O'Connor PW,Oger JJ,Reder AT,Stevens JC

    更新日期:2007-03-27 00:00:00

  • PRRT2 mutations: a major cause of paroxysmal kinesigenic dyskinesia in the European population.

    abstract:OBJECTIVE:Paroxysmal kinesigenic dyskinesia (PKD) is a rare disorder characterized by recurrent attacks of hyperkinetic movements. PKD can be isolated or associated with benign infantile seizures as part of the infantile convulsions with choreoathetosis (ICCA) syndrome. Mutations in the PRRT2 gene were recently identif...


    pub_type: 杂志文章


    authors: Méneret A,Grabli D,Depienne C,Gaudebout C,Picard F,Dürr A,Lagroua I,Bouteiller D,Mignot C,Doummar D,Anheim M,Tranchant C,Burbaud P,Jedynak CP,Gras D,Steschenko D,Devos D,Billette de Villemeur T,Vidailhet M,Brice A,

    更新日期:2012-07-10 00:00:00

  • Increasing comorbidity and health services utilization in older adults with prior stroke.

    abstract:OBJECTIVE:To characterize comorbid chronic conditions, describe health services use, and estimate health care costs among community-dwelling older adults with prior stroke. METHODS:This is a retrospective cohort study using administrative data from Ontario, Canada. We identified all community-dwelling individuals aged...


    pub_type: 杂志文章


    authors: Gruneir A,Griffith LE,Fisher K,Panjwani D,Gandhi S,Sheng L,Patterson C,Gafni A,Ploeg J,Markle-Reid M

    更新日期:2016-11-15 00:00:00

  • Airborne rabies encephalitis: demonstration of rabies virus in the human central nervous system.

    abstract::A veterinarian contracted rabies in the course of laboratory work with homogenates of rabid goat brain. Epidemiologic study determined a respiratory mode of transmission. After a fulminant encephalitic illness, formed rabies virions were identified in the synaptic zones of the olfactory glomeruli. Identification, isol...


    pub_type: 杂志文章


    authors: Conomy JP,Leibovitz A,McCombs W,Stinson J

    更新日期:1977-01-01 00:00:00

  • Homozygosity for the transthyretin-Met30 gene in three Japanese siblings with type I familial amyloidotic polyneuropathy.

    abstract::We report the cases of three siblings homozygous for a mutated transthyretin (TTR) gene that causes type I familial amyloidotic polyneuropathy (FAP), in whom we made the diagnosis by identifying both the mutated TTR gene and a variant TTR in their sera. Their serum levels for the variant TTR are twice those of patient...


    pub_type: 杂志文章


    authors: Yoshinaga T,Nakazato M,Ikeda S,Ohnishi A

    更新日期:1992-10-01 00:00:00

  • Cerebral microbleeds are a risk factor for warfarin-related intracerebral hemorrhage.

    abstract:BACKGROUND:Cerebral microbleeds are known to be indicative of bleeding-prone microangiopathy and may predict incident intracerebral hemorrhage (ICH). In this study, we investigated whether microbleeds are associated with the incidence of warfarin-related ICH. METHODS:Twenty-four patients with ICH while on outpatient t...


    pub_type: 杂志文章


    authors: Lee SH,Ryu WS,Roh JK

    更新日期:2009-01-13 00:00:00

  • Antigen processing gene polymorphisms in HLA-DR2 multiple sclerosis.

    abstract::The association between multiple sclerosis (MS) and alleles of the HLA class II genes indicates that at least one MS susceptibility gene is linked to the HLA class II region. However, the actual locus responsible has not been precisely identified. The recent cloning of new genes involved in antigen processing that map...


    pub_type: 杂志文章


    authors: Liblau R,van Endert PM,Sandberg-Wollheim M,Patel SD,Lopez MT,Land S,Fugger L,McDevitt HO

    更新日期:1993-06-01 00:00:00

  • Antiepileptic drug treatment following temporal lobectomy.

    abstract::Antiepileptic drug use was documented before and after temporal lobectomy. Carbamazepine, phenytoin, and clobazam were the most commonly used drugs, both pre- and postoperatively. Preoperatively, polytherapy was used in 78% of patients; at 6 months follow-up, 47%; at 12 months, 18%; and at 24 months, 14%. Preoperative...


    pub_type: 临床试验,杂志文章


    authors: Maher J,McLachlan RS

    更新日期:1998-07-01 00:00:00

  • The treatment of postprandial hypotension in autonomic failure with 3,4-DL-threo-dihydroxyphenylserine.

    abstract::Postprandial hypotension occurs commonly in patients with autonomic failure and may be due to attenuation of the normal sympathetic nervous system activation in response to meal ingestion. In a randomized, double-blind, placebo-controlled study, we investigated the therapeutic effect of the norepinephrine precursor 3,...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Freeman R,Young J,Landsberg L,Lipsitz L

    更新日期:1996-12-01 00:00:00

  • Pathophysiologic insights into motor axonal function in Kennedy disease.

    abstract:OBJECTIVE:Kennedy disease (KD), or spinobulbomuscular atrophy, is a slowly progressive inherited neurodegenerative disorder, marked by prominent fasciculations that typically precede the development of other symptoms. Although the genetic basis of KD relates to triplet (CAG) repeat expansion in the androgen receptor (A...


    pub_type: 杂志文章


    authors: Vucic S,Kiernan MC

    更新日期:2007-11-06 00:00:00

  • Surgery for intracerebral hemorrhage.

    abstract::Intracerebral hemorrhage (ICH) represents 8 to 15% of all strokes in the United States and 20 to 30% of all strokes in Japan and China. Although ICH represents a relatively small fraction of total strokes, it is a formidable disease, with a 30-day mortality rate two- to sixfold higher than that for ischemic stroke. Fu...


    pub_type: 杂志文章,评审


    authors: Fayad PB,Awad IA

    更新日期:1998-09-01 00:00:00

  • Temporal reorganization to overcome monocular demyelination.

    abstract:OBJECTIVE:To identify the source of delayed visual evoked potential (VEP) latencies in the fellow eyes of patients with optic neuritis (ON) and determine whether these latencies stem from clinically silent demyelination or reflect an adaptive process for synchronization with the affected eyes. METHODS:The study sample...


    pub_type: 杂志文章


    authors: Raz N,Chokron S,Ben-Hur T,Levin N

    更新日期:2013-08-20 00:00:00

  • Characterization of patients with longstanding idiopathic REM sleep behavior disorder.

    abstract:OBJECTIVE:To evaluate the presence of prodromal markers of Parkinson disease (PD) in patients with longstanding idiopathic REM sleep behavior disorder (IRBD), a small subgroup of individuals with IRBD with long-term follow-up thought not to be at risk of developing PD. METHODS:Demographic, clinical, and neuroimaging m...


    pub_type: 杂志文章


    authors: Iranzo A,Stefani A,Serradell M,Martí MJ,Lomeña F,Mahlknecht P,Stockner H,Gaig C,Fernández-Arcos A,Poewe W,Tolosa E,Högl B,Santamaria J,SINBAR (Sleep Innsbruck Barcelona) group.

    更新日期:2017-07-18 00:00:00