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Early Functional Outcomes for Pediatric Patients Diagnosed with Anti-NMDA Receptor Encephalitis during Inpatient Rehabilitation

Howarth, Robyn A., PhD1; Vova, Joshua, MD2; Blackwell, Laura S., PhD1

American Journal of Physical Medicine & Rehabilitation: October 30, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHM.0000000000001087
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Objective The aims of the current study were to characterize the demographic and clinical presentation of pediatric patients diagnosed with anti-NMDA receptor encephalitis who require inpatient rehabilitation, to examine early functional outcomes, and to investigate predictors of early recovery.

Design A retrospective chart review was conducted for 27 pediatric patients diagnosed with anti-NMDA receptor encephalitis who received intensive inpatient neurorehabilitation.

Results On average, patients were 10.6 years of age (range 2-18) at the time of symptom onset. Average time to treatment from symptom onset was 27.2 days (range 5-91). Patients displayed significant improvements between admission and discharge WeeFIM DFQ scores across patients (p<.01). Mean WeeFIM Total DFQ score at admission was 28.6 (range 15.0 – 62.6) and at discharge was 54.3 (range 14.2 - 91.9). Younger age at onset, seizures, and number of treatments received was associated with worse functional outcomes at discharge. Time to initiate treatment was not found to be associated with early functional outcomes.

Conclusion Pediatric patients diagnosed with anti-NMDA receptor encephalitis displayed significant functional gains during inpatient rehabilitation, despite persistent functional deficits at discharge, suggesting the need for ongoing monitoring and intervention.

Departments of Neuropsychology,1 Physical Medicine & Rehabilitation,

2 Children's Healthcare of Atlanta; Emory University School of Medicine, Atlanta, Georgia

Correspondence: Robyn A. Howarth, PhD, Children’s Healthcare of Atlanta, Department of Neuropsychology, 5461 Meridian Mark Road, Suite 180, Atlanta, GA 30342, Phone: 404-785-2849, Fax: 404-785-2851, Email: robyn.howarth@choa.org

Author Disclosures: none

Funding: no funding was received

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