RECOVERY OF COGNITIVE, ACADEMIC AND ADAPTIVE FUNCTIONING IN PEDIATRIC ANTI-NMDAR: SERIAL NEUROPSYCHOLOGICAL DATA FOR A 16-YEAR-OLD BILINGUAL FEMALE

RECOVERY OF COGNITIVE, ACADEMIC AND ADAPTIVE FUNCTIONING IN PEDIATRIC ANTI-NMDAR: SERIAL NEUROPSYCHOLOGICAL DATA FOR A 16-YEAR-OLD BILINGUAL FEMALE

Mairim Vega, Psy.D.1; Eyal Muscal M.D.2 and Karen Evankovich Ph.D.2

Abstract

Objective. Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR), the second-most frequent cause of autoimmune encephalitis in children, has been asso- ciated with severe cognitive deficits disproportionate to the severity of the clinical presentation. Studies have suggested the presence of long-term persistent deficits in cognitive functioning. In this case study we present the clinical course description and cognitive recovery of a previously high functioning 16-year-old, bilingual, Hispanic female.

Method. We present serial neuropsychological data of a previously high-functioning 16-year-old female.

Results. Neuropsychological evaluations conducted at 5 and 9 months post symptom onset revealed persistent global deficits in cognitive, academic, and adaptive functioning necessitating repeat rituximab dosing and ongoing treatment with mycophenolate. Most areas of functioning improved to the average range by the 22-month follow-up although serum antibodies remained elevated.

Conclusion. Neuropsychological data proved to be a better indicator of the patient’s recovery of “real-world” functioning than clinical observations or serum antibody titers, underscoring the importance of neuropsychological evaluations for these patients.

1 Carlos Albizu University, Mayagüez Campus
2 Texas Children’s Hospital/Baylor College of Medicine

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