Brain MRI Findings in Pediatric Anti-NMDAR Encephalitis

Anti–N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a treatable autoimmune disorder. MRI findings have been well described in adults but not children. Investigators have now reviewed MRI scans of 38 children from nine European hospitals and compared them with a healthy children imaging repository.

MRI at disease onset was abnormal in 40%, including T2 hyperintense white-matter lesions, cortical lesions, focal or global atrophy, and abnormal signal in the hippocampus and thalamus. MRI volume analysis revealed whole brain and gray matter atrophy, including in the hippocampus, thalamus, putamen, caudate, and brainstem. Compared with controls, patients had persistently reduced brain volume over time. Worse clinical outcomes at a medi…