The Leading Role of Brain and Abdominal Radiological Features in the Work-Up of Anti-NMDAR Encephalitis in Children: An Up-To-Date Review

Author:

Guarino Miriana1ORCID,La Bella Saverio1ORCID,Santoro Marco2,Caposiena Daniele2,Di Lembo Enza3,Chiarelli Francesco1,Iannetti Giovanni3

Affiliation:

1. Department of Pediatrics, University of Chieti-Pescara “G. D’Annunzio”, Via Dei Vestini 5, Ospedale Clinicizzato Chieti (CH), 66100 Chieti, Italy

2. Department of Radiology, Pescara Public Hospital “Santo Spirito”, 65124 Pescara, Italy

3. Department of Internist Ultrasound, Pescara Public Hospital “Santo Spirito”, 65124 Pescara, Italy

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis (NMDARe) is the most common cause of nonviral encephalitis, mostly affecting young women and adolescents with a strong female predominance (F/M ratio of around 4:1). NMDARe is characterized by the presence of cerebrospinal fluid (CSF) antibodies against NMDARs, even though its pathophysiological mechanisms have not totally been clarified. The clinical phenotype of NMDARe is composed of both severe neurological and neuropsychiatric symptoms, including generalized seizures with desaturations, behavioral abnormalities, and movement disorders. NMDARe is often a paraneoplastic illness, mainly due to the common presence of concomitant ovarian teratomas in young women. Abdominal ultrasonography (US) is a key imaging technique that should always be performed in suspected patients. The timely use of abdominal US and the peculiar radiological features observed in NMDARe may allow for a quick diagnosis and a good prognosis, with rapid improvement after the resection of the tumor and the correct drug therapy.

Publisher

MDPI AG

Subject

General Neuroscience

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