RT期刊文章SR电子T1 Anti-NMDA受体脑炎老年人协会和延迟诊断,治疗,更糟的是临床结果(10 - 2.003)摩根富林明神经病学神经学乔FD Lippincott Williams &威尔金斯SP 10 - 2.003 OP 10 - 2.003签证官80是7补充A1 Maarten Titulaer A1林赛McCracken A1尼首页Gabilondo A1孝宏Iizuka A1和泉Kawachi A1默娜丽塔·罗森菲尔德A1 Balice-Gordon A1弗朗西斯克格劳A1约瑟Dalmau年2013 UL //www.ez-admanager.com/content/80/7_Supplement/IN10-2.003.abstract AB目的:描述Anti-NMDA受体脑炎在老年患者的临床情况来提高识别和结果。背景:Anti-NMDAR脑炎是一种新型的疾病主要在年轻的人。老年人疾病的表现是未知的。设计/方法:队列研究,考察人口统计,出现症状,治疗,和长期随访。结果:在症状出现,31岁的661名患者(5%)与anti-NMDAR脑炎是44岁以上。14(45%)是男性与12%相比年轻人(18-44岁,p < 0.001)。七个(23%)有一个潜在的肿瘤相比,51%在年轻的成年人(p = 0.002)。只有两个患者卵巢肿瘤(一个畸胎瘤,一个间质性肿瘤线);其它的五种肿瘤的乳腺癌、肺癌,或胸腺。最常见的初期症状是记忆和行为的改变(分别为16%和58%)。诊断和治疗的平均时间为7周和4周在年轻的成年人(p = 0.015)。 At presentation, the most common differential diagnoses included, limbic encephalitis, HSV or bacterial meningoencephalitis, leptomeningeal metastases, vasculitis, and Creutzfeldt-Jakob disease. Brain MRI was more frequently abnormal than in younger adults (53% vs 35%, p=0.049). The maximum severity of disease measured with the modified Rankin Scale (mRS) was lower in elder patients: 74% had mRS of 5 and 58% required ICU care, vs 87% and 80% in younger adults (p=0.056 and p=0.011, respectively). Despite the decreased severity of symptoms, outcome was worse in older patients: 64% had full or substantial recovery (mRS 0-2) at 24 months vs 81% in younger adults (p<0.05).CONCLUSIONS: Anti-NMDA receptor encephalitis occurs less frequently in older adults, but it appears to be underdiagnosed. In patients older than 44 years, there is less predominance of women and the tumors are more diverse. The recognition of the disorder in this age group is less suspected leading to delay in diagnosis, treatment, and worse outcome.Supported by: MT is supported by a KWF fellowship 2009-4451 of the Dutch Cancer Society. Supported in part by NIH RO1NS077851 (JD), RO1CA89054 (JD), and RC1NS068204 (RB-G & JD); a McKnight Neuroscience of Brain Disorders award (RB-G & JD), Fondo de Investigaciones Sanitarias (FIS, Spain, 11/01780, JD; PS09/0193, FG), and Fundació la Marató de TV3 (JD).Disclosure: Dr. Titulaer has nothing to disclose. Dr. McCracken has nothing to disclose. Dr. Gabilondo has nothing to disclose. Dr. Iizuka has nothing to disclose. Dr. Kawachi has nothing to disclose. Dr. Rosenfeld has received personal compensation for activities with Genetech, Inc., Merck & Co., Inc. as an advisory board member. Dr. Rosenfeld has received personal compensation in an editorial capacity for UpToDate, Inc., McGraw Hill Current Medicine Group LLC. Dr. Rosenfeld has received (royalty or license fee or contractual rights) payments from Memorial Sloan-Kettering Cancer Center and University of Pennsylvania. Dr. Balice-Gordon has received personal compensation for activities with Pfizer, Inc. Dr. Graus has nothing to disclose. Dr. Dalmau has received personal compensation in an editorial capacity for UpToDate. Dr. Dalmau has received royalty payments from Athena Diagnostics. Dr. Dalmau has received research support from Euroimmun.Friday, March 22 2013, 8:00 am-12:00 pm