[Clinical Manifestations and Complications in Patients with Anti-NMDA Receptor Encephalitis]

Abstract

Objective: To investigate the clinical manifestations and complications in the patients of anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis.

Methods: We retrospectively collected clinical data of 143 patients diagnosed with anti-NMDA receptor encephalitis. According to the complexity of clinical symptoms, the patients were divided into two groups: ≥4 clinical symptoms group (96 cases, 67.1%) and <4 group (47 cases, 32.9%). There were 109 patients with complications and 34 patients without any complicaitons, The related factors to symptom complexity and complications were analyzed by univariate and multivariate analysis method.

Results: In the 143 patients of anti-NMDA receptor encephalitis, 120 (83.9%) exhibited seizures, 130 (90.9%) presented with psychiatric symptoms. Pulmonary infections (58.7%) and gastrointestinal disorders (49.0%) were the most common complications. Univariate analysis showed that the complexity of clinical symptoms was related to abnormal electroencephalography (EEG), positive anti-NMDA receptor antibody in cerebrospinal fluid(CSF) and serum. There were more frequent seizures, disorders of consciousness, abnormal movements, central hypoventilation in the patients with complications than those in patients without complications, all the differences were signifcant (P<0.05). Multivariate analysis showed that abnormal EEG was an independent risk factor for symptom complexity 〔odds ratio(OR)=2.620, P<0.05〕. The abnormal movements and the activities of daily living (ADL) on admission were predictor factors for the incidence of complications (OR=4.338, 0.980, respectively, P<0.05).

Conclusions: In the patients of anti-NMDA receptor encephalitis, abnormal EEG may related to more complex clinical symptoms. Abnormal movements and low ADL on admission seems to be independent risk factors related to the incidence of complications.

Keywords: Anti-NMDA receptor; Complication; Encephalitis; Factor analysis.