Unilateral predominance of abnormal movements: A characteristic feature of the pediatric anti-NMDA receptor encephalitis?

Vanessa Benjumea-Cuartas; Monika Eisermann; Hina Simonnet; Marie Hully; Rima Nabbout; Isabelle Desguerre; Anna Kaminska

doi:10.1016/j.ebcr.2016.12.002

Unilateral predominance of abnormal movements: A characteristic feature of the pediatric anti-NMDA receptor encephalitis?

Epilepsy Behav Case Rep. 2017 Jan 18:7:42-44. doi: 10.1016/j.ebcr.2016.12.002. eCollection 2017.

Authors

Vanessa Benjumea-Cuartas¹, Monika Eisermann², Hina Simonnet³, Marie Hully³, Rima Nabbout⁴, Isabelle Desguerre³, Anna Kaminska²

Affiliations

¹ Department of Epilepsy, Neurocentro, Pereira, Colombia.
² Department of Clinical Neurophysiology, Necker-Enfants Malades Hospital, APHP, Paris, France; INSERM U1129, Paris, France; Paris Descartes University, Sorbonne Paris Cité; CEA, Gif sur Yvette, France.
³ Reference Center for Rare Epilepsies, APHP, Necker-Enfants Malades Hospital, Paris, France.
⁴ INSERM U1129, Paris, France; Paris Descartes University, Sorbonne Paris Cité; CEA, Gif sur Yvette, France; Department of Pediatric Neurology, APHP, Necker-Enfants Malades Hospital, Paris, France; Reference Center for Rare Epilepsies, APHP, Necker-Enfants Malades Hospital, Paris, France.

Abstract

Anti-NMDA receptor encephalitis is a treatable autoimmune disease characterized by cognitive, motor and psychiatric features that primarily affects young adults and children. We present a case of a 7-year-old boy with asymmetrical (mainly right hemibody) and abnormal polymorphic movements without concomitant scalpictal EEG changes but had background slowing predominating over the left hemisphere. This report illustrates previous descriptions of asymmetric presentation of abnormal movements in pediatric anti-NMDA receptor encephalitis and emphasizes the importance of video-EEG interpreted within the overall clinical context, to differentiate epileptic from non-epileptic abnormal movements in patients with autoimmune encephalitis.

Keywords: Abnormal movements; Anti-NMDA receptor encephalitis; CSF, cerebrospinal fluid; CT, computed tomography; EEG, electroencephalogram; IV, intravenous; MRI, magnetic resonance imaging; NMDA, N-Methyl-d-aspartate; Video-EEG.

Publication types

Case Reports