Adult anti-NMDA receptor encephalitis: Which physical and rehabilitation medicine program? Case reports and literature review




Objective


Anti-NMDA (N-Methyl-D-Aspartate) receptor encephalitis (NMDA-E) is the second cause of autoimmune encephalitis in adults. The objectives of this presentation are to describe the main clinical elements and rehabilitation specificities.


Observations


Three female inpatients (mean age: 25) present with moderate to severe behavioural and/or psychiatric disorders, seizures and presence of associated tumor in one patient. Presence of anti-NMDA antibodies in the cerebrospinal liquid confirmed diagnosis. Rehabilitation was focused on cognitive and behavioural remediation, dysphagia rehabilitation (2 patients) and on functional mobility improvement and regular psychiatric assessment. Functional outcome was satisfactory. Return to previous activities (high school and college) was obtained for 2 cases, respectively at 22 and 6 months of evolution.


Discussion – conclusion


Four cases with description of rehabilitation procedures are found in literature: 3 women (mean age: 25) benefit from specific rehabilitation program (physiotherapy, neuropsychology, and speech therapy) with medium-term improvement; and 1 young girl, with physical reconditioning and neuropsychology sessions, allowing return to high school with specific adaptations. Main features for E-NMDA rehabilitation combine neurocognitive and behavioral support. Regular psychiatric monitoring is necessary. Though functional prognosis is good, return to previous activities isn’t systematic.


Disclosure of interest


The authors have not supplied their declaration of competing interest.

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Apr 20, 2017 | Posted by in PHYSICAL MEDICINE & REHABILITATION | Comments Off on Adult anti-NMDA receptor encephalitis: Which physical and rehabilitation medicine program? Case reports and literature review

Full access? Get Clinical Tree

Get Clinical Tree app for offline access