Neurocritical care for Anti-NMDA receptor encephalitis
| Autor: | Jann-Jim Lin, Kuang-Lin Lin |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Pediatrics medicine.medical_specialty Autonomic dysfunction Status epilepticus Receptors N-Methyl-D-Aspartate law.invention 03 medical and health sciences 0302 clinical medicine law Intensive care Humans Medicine Intensive care unit lcsh:QH301-705.5 Anti-N-Methyl-D-Aspartate Receptor Encephalitis Pediatric intensive care unit Anti-NMDA receptor encephalitis lcsh:R5-920 business.industry Neurointensive care General Medicine medicine.disease Hypoventilation 030104 developmental biology NMDA lcsh:Biology (General) Part III. Specific Challenging Neurocritical Diseases in Children Review Article 030220 oncology & carcinogenesis Schizophrenia Encephalitis medicine.symptom lcsh:Medicine (General) business |
| Zdroj: | Biomedical Journal, Vol 43, Iss 3, Pp 251-258 (2020) Biomedical Journal |
| ISSN: | 2319-4170 |
| Popis: | In this review, we summarize the clinical presentations of the acute stage of anti-N-methyl-d-aspartate (NMDA) receptor encephalitis and the neurocritical care strategy in intensive care units. Anti-NMDA receptor encephalitis has characteristic clinical features and is predominantly seen in young adults and children. Most patients have five stages of clinical presentation, including a prodromal phase, psychotic and/or seizure phase, unresponsive and/or catatonic phase, hyperkinetic phase, and gradual recovery phase. The clinical course usually begins with viral infection-like symptoms that last for up to 2 weeks (prodromal phase), followed by the rapid development of schizophrenia-like psychiatric symptoms and seizures (psychotic and seizure phase). Patients may have a decreased level of consciousness with central hypoventilation, frequently requiring mechanical ventilation. In the subsequent hyperkinetic phase, patients present with orofacial-limb dyskinesia and autonomic instability. Children with significant neurological symptoms of anti-NMDA receptor encephalitis should initially be managed in a pediatric intensive care unit. The acute critical presentations are, refractory seizures, autonomic dysfunction, hypoventilation, cardiac arrhythmia, and hyperkinetic crisis. Symptom-guided therapies and critical care are necessary in the acute stage to improve the prognosis. |
| Databáze: | OpenAIRE |
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