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Successful treatment of antiN-methyl-d-aspartate receptor limbic encephalitis in a 22-monthold child with plasmapheresis and pharmacological immunomodulation
  1. Shakti Agrawal1,
  2. Angela Vincent2,
  3. Leslie Jacobson2,
  4. David Milford1,
  5. Rajat Gupta1,
  6. Evangeline Wassmer1
  1. 1Department of Paediatric Neurology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham UK B4 6NH, UK
  2. 2Neurosciences Group, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Dr Shakti Agrawal, Department of Neurology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH.

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We report the case of a previously healthy 22-month-old girl who presented with the full clinical spectrum of anti-N-methyl-daspartate receptor (NMDAR) encephalitis with seizures, agitation, stupor, autonomic instability, dysphagia and relentless choreoathetoid movements.

Schimmel et al describe a 12-year-old girl with typical clinical symptoms of the recently described NMDAR encephalitis.1 Their patient was the youngest reported case with this condition to date.

The symptoms in our patient began 1 week after a meningitis C booster vaccination. Cerebrospinal fluid (CSF) examination on admission showed raised lymphocyte count and oligoclonal bands with no oligoclonal bands in a paired blood sample. All other investigations including PCR for …

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