Talk:Anti-NMDA receptor encephalitis

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Addition to Symptoms

After reading the book Brain on Fire by Susannah Cahalan, I feel the symptoms she had along with the many people she talked to are important. I think the biggest symptom that needs to be added to this list is the fact that she had a tingly, numbness feeling on her left side of the body. Doctors couldn't figure this out and ignored it, but Dr. Najjar, who diagnosed her with Anti-NMDA receptor encephalitis, came up with this conclusion after he gave her a piece of paper and told her to draw a clock. Susannah drew numbers 1-12 all on the right side of the paper, leading to the conclusion that her right side of the brain was inflamed, and this is what caused the numbness on the left side.

Recovery

The recovery process from anti-NMDA encephalitis can take many months. The symptoms reappear in reverse order. The patient may begin to experience psychosis, leading many people to falsely believe the patient is not recovering. As the recovery process continues on, the psychosis fades. Lastly, the patient's social behavior and executive functions begin to improve. ^[1]

A new review came out in Lancet

A new review came out in Lancet, must be a great secondary source.^[2] I'm going to add one fact from it, maybe more. Firstly, it mentions herpesviral encephalitis as a confirmed trigger of the disease, on par with tumors. --CopperKettle 15:52, 8 November 2019 (UTC)[reply]

References

^ Dalmau, J; Lancaster, E; Martinez-Hernandez, E; Rosenfeld, MR; Balice-Gordon, R (January 2011). "Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis.". The Lancet. Neurology 10 (1): 63–74. doi:10.1016/s1474-4422(10)70253-2. PMC 3158385. PMID 21163445.
^ Dalmau J, Armangué T, Planagumà J, Radosevic M, Mannara F, Leypoldt F, Geis C, Lancaster E, Titulaer MJ, Rosenfeld MR, Graus F (November 2019). "An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: mechanisms and models". The Lancet. Neurology. 18 (11): 1045–1057. doi:10.1016/S1474-4422(19)30244-3. PMID 31326280.

Livmein (talk) 03:31, 16 April 2015 (UTC)livmein[reply]

Frequency

There's no way that this condition is "frequent." I've spoken with multiple ER doctors, a rheumatologist, and a neurologist, and none of them have ever experienced this, and I don't think any of them had ever heard of it. Autoimmune neurological conditions are rarely tested for. The study in the footnote of the study cited for frequency on this page used a very small sample size (about 500 ICU admissions.) See for yourself: Prüss H, Dalmau J, Harms L, Höltje M, Ahnert-Hilger G, Borowski K, Stoecker W, Wandinger KP. Retrospective analysis of NMDA receptor antibodies in encephalitis of unknown origin. Neurology. 2010 Nov 9;75(19):1735-9. doi: 10.1212/WNL.0b013e3181fc2a06. PMID: 21060097.

According to the study below, "Between September 2007 and February 2011, the California Encephalitis Project examined referrals of 761 patients presenting with encephalitis. Of the cases of identified aetiology, anti-NMDA receptor encephalitis was the leading entity (32 of 79 cases)" So, out of the entire population of California (32 million), only 32 cases of anti-NMDA receptor encephalitis were reported over about 3.5 years. That puts the occurrence of this condition at around 1 in 3 million. That's far from being common.

Barry, H., Byrne, S., Barrett, E., Murphy, K. C., & Cotter, D. R. (2015). Anti-N-methyl-d-aspartate receptor encephalitis: review of clinical presentation, diagnosis and treatment. BJPsych bulletin, 39(1), 19-23. At https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495821/ Devingbost (talk) 06:34, 23 September 2021 (UTC)[reply]

Also, I want to point out that the sample size of 500 (mentioned above) wasn't from the general population, it was from ICU admissions. So, that makes it even less common. Devingbost (talk) 06:37, 23 September 2021 (UTC)[reply]

If the average person lives for 82 years, then this rate (from the figures above) puts the lifetime risk of being diagnosed with this condition at about 1 in 234,000. That number meets the criteria of a "rare disease," according to the website below, because it's less than 1 in 200,000. https://rarediseases.info.nih.gov/diseases/pages/31/faqs-about-rare-diseases Devingbost (talk) 07:59, 23 September 2021 (UTC)[reply]

[1] Dalmau, J; Lancaster, E; Martinez-Hernandez, E; Rosenfeld, MR; Balice-Gordon, R (January 2011). "Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis.". The Lancet. Neurology 10 (1): 63–74. doi:10.1016/s1474-4422(10)70253-2. PMC 3158385. PMID 21163445.

[pmid31326280-2] Dalmau J, Armangué T, Planagumà J, Radosevic M, Mannara F, Leypoldt F, Geis C, Lancaster E, Titulaer MJ, Rosenfeld MR, Graus F (November 2019). "An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: mechanisms and models". The Lancet. Neurology. 18 (11): 1045–1057. doi:10.1016/S1474-4422(19)30244-3. PMID 31326280.

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