Browsing by Author "Topaloglu, Haluk"

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    Clinical Presentation of Anti-N-Methyl-D-Aspartate Receptor and Anti-Voltage-Gated Potassium Channel Complex Antibodies in Children: A Series Of 24 Cases
    (2018) Konuskan, Bahadir; Yildirim, Mirac; Topaloglu, Haluk; Erol, Ilknur; Oztoprak, Ulkuhan; Tan, Huseyin; Gocmen, Rahsan; Anlar, Banu; https://orcid.org/0000-0002-3530-0463; 29153996; AAK-4825-2021
    Objective: The symptomatology and paraclinical findings of antibody-mediated encephalitis, a relatively novel disorder, are still being characterized in adults and children. A high index of suspicion is needed in order to identify these cases among children presenting with various neurological symptoms. The aim of this study is to examine the clinical, demographic and laboratory findings and outcome of children with anti-NMDAR and anti-VGKC encephalitis for any typical or distinctive features. Methods: Cases diagnosed with anti-N-Methyl o-aspartate receptor (NMDAR) and anti voltage gated potassium channel (VGKC) antibody-mediated encephalopathy in four major child neurology centers are described. Results: In four years, 16 children with NMDAR and 8 children with VGKC antibody associated disease were identified in the participating centers. The most frequent initial manifestation consisted of generalized seizures and cognitive symptoms in both groups. Movement abnormalities were frequent in anti-NMDAR patients and autonomic symptoms, in anti-VGKC patients. Cerebrospinal fluid (CSF) protein, cell count and IgG index were normal in 9/15 anti-NMDAR and 5/8 anti-VGKC patients tested. EEG and MRI findings were usually nonspecific and non-contributory. The rate and time of recovery was not related to age, sex, acute or subacute onset, antibody type, MRI, EEG or CSF results. Treatment within 3 months of onset was associated with normal neurological outcome. Conclusions: Our results suggest anti-NMDAR and VGKC encephalopathies mostly present with non-focal neurological symptoms longer than 3 weeks. In contrast with adult cases, routine CSF testing, MRI and EEG did not contribute to the diagnosis in this series. (C) 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
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    Electroencephalographic Findings in Anti-N-Methyl-D-Aspartate Receptor Encephalitis in Children: A Series Of 12 Patients
    (2018) Yildirim, Mirac; Konuskan, Bahadir; Yalnizoglu, Dilek; Topaloglu, Haluk; Erol, Ilknur; https://orcid.org/0000-0002-3530-0463; 29179102; AAK-4825-2021
    Objective: Anti-N-methyl-D-aspartate receptor encephalitis (a-NMDARe) is an acute or subacute encephalopathy where electroencephalogram (EEG) is frequently obtained as part of the workup. Although no diagnostic EEG finding has been described so far, the definition of specific or typical patterns might help to distinguish this group among various encephalopathies of childhood. We examined EEG recordings of our patients with a-NMDARe in order to describe the most frequent findings. Methods: Clinical and laboratory data and digital EEG recordings of 12 pediatric patients diagnosed with a-NMDARe in two major child neurology centers are evaluated. Results: We reviewed 43 EEG recordings from 12 children with a-NMDARe and followed their evolution for a median of 6 (range: 1-60) months. Initial EEG was abnormal in 11/12 patients. The most frequent finding was focal or diffuse slowing of the background rhythm. Generalized rhythmic delta activity, brief rhythmic discharges (BRDs), and occipital intermittent rhythmic delta activity (OIRDA) were seen in two patients each. Diffuse excess beta frequency activity was seen in three patients. Extreme delta brushes were observed in 5/12 (41.7%) patients, disappeared in 4-6 months (two patients), or persisted at 10-17 months (two patients). Epileptic activity was seen in seven patients (58%) and lateralized periodic discharges in one. On follow-up EEGs, most epileptic activity disappeared in a median of 8 months. Conclusions: A normal EEG is rare in a-NMDARe. Focal or diffuse slowing, epileptic activity, and extreme delta brush are common findings. Epileptic activity in early EEGs do not persists in most patients. Severe diffuse slowing may predict neurological impairment if confirmed in larger series. (C) 2017 Elsevier Inc. All rights reserved.