Background: NMDA receptor encephalitis (NMDARE) is the most prevalent autoimmune encephalitis and it encompasses a spectrum of clinical features. It is most commonly associated with alteration in consciousness, seizures, neuro-psychiatric symptoms, and movement disorders. Electroencephalography (EEG) plays a vital role and can give clues to diagnosis in a subset of patients. Methods: We retrospectively characterized the clinical and EEG findings in our NMDARE patients (n = 48). A total of 131 EEGs were analyzed. Results: We observed that patients with seizures had a younger age of onset (p < 0.001). The most common EEG pattern that was noted was diffuse slowing (n = 20) followed by generalized rhythmic delta activity (n = 9), focal spikes and slowing (n = 8 each). Delta brush pattern was seen in only 3 EEGs. Focal ictal rhythms were seen in 3 EEGs. There was no significant difference in outcomes such as seizure recurrence, modified Rankin score (mRS) at follow up/discharge or relapse between groups of patients who had EEG abnormalities in the first EEG and with those who did not. Conclusions: NMDARE has varied EEG findings, most of them being non-specific. When combined with clinical presentation, EEG is a useful tool in the diagnosis and management of NMDARE.


中文翻译：

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抗 NMDAR 脑炎脑电图变化谱及演变


背景： NMDA 受体脑炎 (NMDARE) 是最普遍的自身免疫性脑炎，它包含一系列临床特征。它最常与意识改变、癫痫发作、神经精神症状和运动障碍有关。脑电图 (EEG) 起着至关重要的作用，可以为部分患者的诊断提供线索。方法：我们回顾性描述了 NMDARE 患者 (n = 48) 的临床和脑电图结果。共分析了 131 个脑电图。结果：我们观察到癫痫患者的发病年龄较小（p < 0.001）。最常见的脑电图模式是弥漫性减慢（n = 20），然后是广义节律性 delta 活动（n = 9）、局灶性尖峰和减慢（每个 n = 8）。仅在 3 个 EEG 中看到 Delta 刷模式。3 例脑电图中可见局灶性发作节律。在第一次 EEG 中出现 EEG 异常的患者组与未出现 EEG 异常的患者组之间，癫痫复发、随访/出院时改良 Rankin 评分 (mRS) 或复发等结果没有显着差异。结论： NMDARE 有不同的脑电图结果，其中大多数是非特异性的。结合临床表现，EEG 是 NMDARE 诊断和管理的有用工具。