Long‐term outcome of paediatric anti‐N‐methyl‐D‐aspartate receptor encephalitis.

Aim: To study long‐term clinical and cognitive outcomes of patients with anti‐N‐methyl‐d‐aspartate receptor encephalitis (NMDAR‐E), an acute autoimmune neurological disease with severe acute presentations. Method: In this French multicentre retrospective observational cohort study, patients no older than 18 years with a follow‐up of at least 2 years were included. Data from clinical and cognitive assessments were collected. Results: Eighty‐one patients were included (57 females, 24 males; median age 10 years 7 months [range 1–18 years], median follow‐up 40 months [range 25–53 months]). At last follow‐up, 35 patients (45%) had cognitive impairment, 48 (70%) had academic difficulties, and 65 (92%) needed rehabilitation. Seventy‐one patients (88%) had a modified Rankin Scale score of no more than 2. A higher number of symptoms at diagnosis was associated with cognitive impairment (p = 0.01), while an abnormal electroencephalogram at diagnosis increased the risk of academic difficulties (p = 0.03). Interpretation: Although most children with NMDAR‐E seemed to recover from motor disabilities, more than 45% had cognitive and academic difficulties. The initial severity of symptoms seems to have an impact on cognition and academic performances. What this paper adds: Forty‐five per cent of patients had cognitive impairment at ≥2 years diagnosis of anti‐N‐methyl‐d‐aspartate receptor encephalitis (NMDAR‐E).Seventy per cent of patients had academic difficulties at ≥2 years diagnosis of NMDAR‐E.Ninety‐two per cent of patients needed rehabilitative care at ≥2 years diagnosis of NMDAR‐E.A high number of symptoms at diagnosis were associated with cognitive impairment. What this paper adds: Forty‐five per cent of patients had cognitive impairment at ≥2 years diagnosis of anti‐N‐methyl‐d‐aspartate receptor encephalitis (NMDAR‐E).Seventy per cent of patients had academic difficulties at ≥2 years diagnosis of NMDAR‐E.Ninety‐two per cent of patients needed rehabilitative care at ≥2 years diagnosis of NMDAR‐E.A high number of symptoms at diagnosis were associated with cognitive impairment. [ABSTRACT FROM AUTHOR]