Session Information
Session Title: AA 2021 Virtual Posters - Pediatric Rehabilitation
Session Time: None. Available on demand.
Disclosures: Ryan L. Smith, DO: No financial relationships or conflicts of interest
Case Diagnosis: 3 Hispanic Male pediatric patients ages 7 mo-5yrs were diagnosed with Anti-NMDA encephalitis, and had minimal functional improvement during rehabilitation.
Case Description: Over the course of 3 months, 3 children diagnosed with N-Methyl-D-Aspartate receptor encephalitis were admitted to our institution, all of which were young Hispanic males. These children’s hospital lengths of stay were between 1-3 months, and afterwards each spent between 1-2 months in acute inpatient rehabilitation at our institution. All 3 patients presented with symptoms of agitation, dyskinetic movements, seizures, and minimal response to any type of stimuli. One child had a prior diagnosis of HSV encephalitis, the other children having no neoplasms or other clear precipitating factors. While all cases improved medically, they all made minimal functional progress during hospital admission and during acute rehabilitation stay, two eventually needing to be readmitted to the hospital for medical stabilization. All were eventually discharged home with families and close follow up.
Setting: Standalone Adult Rehabilitation Hospital with Pediatric UnitAssessment/
Results: All 3 patients tested positive for NMDA antibodies, and all 3 had very similar initial presentations, length of hospital stays, treatment courses, and rehabilitation courses. Despite intensive rehabilitation, all three children had no significant improvement of their WeeFIM scores after 1 or more months of rehabilitation.
Discussion: As this is a rare and sporadic condition in the pediatric population, this is the first report of this number of pediatric patients with similar demographics presenting to the same institution with analogous clinical presentations, and similar levels of impairment in cognitive and function at time of discharge.
Conclusion: Anti-NMDA encephalitis shows no clear predisposing ethnic, geographic or other epidemiological correlations in the literature. This retrospective case series could be an initial step in the direction of research to identifying such risk factors, and would be a step in the direction of earlier diagnosis and improved outcomes.
Level of Evidence: Level V
To cite this abstract in AMA style:
Smith RL, Wright S. Pediatric Rehabilitation of Three Hispanic Male Children Younger Than 5 Years Old with Anti-n-methyl-d-aspartate Receptor Encephalitis: A Case Series [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/pediatric-rehabilitation-of-three-hispanic-male-children-younger-than-5-years-old-with-anti-n-methyl-d-aspartate-receptor-encephalitis-a-case-series/. Accessed October 8, 2024.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/pediatric-rehabilitation-of-three-hispanic-male-children-younger-than-5-years-old-with-anti-n-methyl-d-aspartate-receptor-encephalitis-a-case-series/