Sudden and isolated Broca's aphasia: a new clinical phenotype of anti NMDA receptor antibodies encephalitis in children

Kumaran Deiva; Maria Carmela Pera; Hélène Maurey; Pascale Chrétien; Frédérique Archambaud; Viviane Bouilleret; Marc Tardieu

doi:10.1016/j.ejpn.2014.06.002

Sudden and isolated Broca's aphasia: a new clinical phenotype of anti NMDA receptor antibodies encephalitis in children

Eur J Paediatr Neurol. 2014 Nov;18(6):790-2. doi: 10.1016/j.ejpn.2014.06.002. Epub 2014 Jun 11.

Authors

Kumaran Deiva¹, Maria Carmela Pera², Hélène Maurey², Pascale Chrétien³, Frédérique Archambaud⁴, Viviane Bouilleret⁵, Marc Tardieu⁶

Affiliations

¹ Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Pediatric Neurology Department, Le Kremlin Bicêtre, France; National Referral Center for Neuro-Inflammatory Diseases in Children and University Paris-Sud, Le Kremlin-Bicêtre, France. Electronic address: kumaran.deiva@bct.aphp.fr.
² Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Pediatric Neurology Department, Le Kremlin Bicêtre, France.
³ Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Immunology Department, Le Kremlin-Bicêtre, France.
⁴ Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Biophysics and Nuclear Medecine Department, Le Kremlin-Bicêtre, France.
⁵ Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Neurophysiology and Epileptology Departement, Le Kremlin-Bicêtre, France.
⁶ Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Pediatric Neurology Department, Le Kremlin Bicêtre, France; National Referral Center for Neuro-Inflammatory Diseases in Children and University Paris-Sud, Le Kremlin-Bicêtre, France.

PMID: 24980905
DOI: 10.1016/j.ejpn.2014.06.002

Abstract

Background: Anti NMDA receptor (anti NMDAR) encephalitis is a well-characterized entity in children associating movement disorders, psychiatric features and speech difficulties. Novel phenotypes have been described in adults.

Methods and results: A 4-year-old girl presented partial seizures which evolved towards sudden and isolated Broca's aphasia. Anti NMDAR antibodies were positive in CSF and serum confirming anti NMDAR encephalitis. Clinical recovery was observed after a specific treatment.

Conclusion: This case widens the clinical spectrum of anti-NMDAR encephalitis in children and awareness of this newly identified symptom is important as early treatment is a predictor of good outcome.

Keywords: Auto immune; Broca's aphasia; Children; Epilepsy; NMDAR encephalitis.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications*
Aphasia, Broca / diagnosis
Aphasia, Broca / diagnostic imaging
Aphasia, Broca / etiology*
Child
Electroencephalography
Female
Fluorodeoxyglucose F18
Humans
Positron-Emission Tomography
Receptors, N-Methyl-D-Aspartate / immunology

Substances

Receptors, N-Methyl-D-Aspartate
Fluorodeoxyglucose F18