الفهرس 
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Abstract
Summary
Autoimmune encephalitis is a type of encephalitis with antibodies to cell surface. This disorder predominates in young women and children although it can affect males and people of all ages (the youngest and the oldest patient described were 2 month and 85 year-old).
The presence of a tumor (mostly an ovarian teratoma) is age dependent, and rarely encountered in patients younger than 12 years. The antibodies target the GluN1 subunit of the NMDAR receptor.
The neuropsychiatric symptoms are often preceded by prodromal headache, fever or other features that may suggest an infection.
In teenagers and young women, the onset is characterized by prominent psychiatric manifestations (delusional thoughts, bizarre behavior, psychosis, catatonia), followed by a decrease of consciousness, seizures, orofacial or limb dyskinesias, and autonomic instability.
In children and adult male patients, the first symptom can be seizures or movement disorders. The
Summary
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differential diagnosis often includes a primary psychiatric disorder, drug abuse, neuroleptic malignant syndrome, or infectious encephalitis.
Due to the frequent presence of prodromal symptoms (hyperthermia, headache, and other), most patients with anti-NMDAR encephalitis are investigated for an infectious etiology.
In a few cases (overall less than 5% of the cases) positive serology for Mycoplasma Pneumoniae, HHV6, or enterovirus have been described; the significance of these findings is currently unclear
Most autoimmune encephalitis associate with cerebrospinal fluid (CSF) lymphocytic pleocytosis that is usually milder than that found in viral etiologies. Patients with viral and autoimmune encephalitis have normal glucose levels and normal or mildly increased protein concentration.
Definitive diagnosis of anti- NMDAR encephalitis is established by demonstrating IgG antibodies to the NR1 subunit in patients’ serum and CSF or CSF only and usually the CSF titre is higher than the serum titre.
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Our study aimed to asses quantitatively NMDAR antibody in CSF and serum samples in a cohort study of children presenting with acute encephalitis by ELISA technique.
The study was performed on 30 children complaining of acute encephalitis, where 16 patient were male, and 14 were female, average age was 16.7±8.07 month, range (2-144) month old.
History taking and clinical examination in details were done to all patients.
Laboratory evaluation by CBC, CRP, Lumbar puncture, CSF analysis, measuring NMDAR antibody titre in serum and CSF.
NMDA receptor antibody titre was done in CSF which range from (21.78 -73.44 pg/ml) with mean of 28.61±9.12, while in serum it range from (19.97-130 pg/ml) with mean 42.49±32.13.
It was found that 7/30 (23%) patients had high NMDA receptor antibody titre, six of them were high in serum and one was high in CSF. The other 23/30 (77%) patients had low NMDAR Antibody titre.
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Significant occurrence of thrombocytopenia, DCL, hospitalization plus mechanical ventilation and long term sequel were detected in patients with high NMDAR antibody titre.