Autoimmune Basal Ganglia Encephalitis Associated With Anti-N-methyl-d-Aspartate Receptor Antibodies in Children

Autoimmunity might cause movement disorders which were described as autoimmune movement disorders. Basal ganglia dysfunction was one of the most involved mechanisms. Some anti-neural antibodies were considered to be related[ 1 Damato V. Balint B. Kienzler A.K. Irani S.R. The clinical features, underlying immunology, and treatment of autoantibody-mediated movement disorders. Mov Disord. 2018; 33: 1376-1389 Crossref Scopus (33) Google Scholar ]. The anti-N-methyl-D-aspartate receptor antibody (NMDAR-Ab) was one of them because of the predominant movement disorders， especially in children[ 2 Baizabal-Carvallo J.F. Stocco A. Muscal E. Jankovic J. The spectrum of movement disorders in children with anti-NMDA receptor encephalitis. Mov Disord. 2013; 28: 543-547 Crossref PubMed Scopus (129) Google Scholar ]. However, most patients had multifocal brain dysfunction other than movement dysfunction， such as behavioral changes, psychiatric disorders, cognitive impairment, seizures, and dysautonomia[ 3 Dalmau J. Armangué T. Planagumà J. et al. An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: mechanisms and models. The Lancet Neurology. 2019; 18: 1045-1057 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar ]. Radiological abnormalities in basal ganglia were rare. Therefore, the pathogenesis of movement disorders caused by NMDAR-Abs was still controversial. Here we reported three cases presented as basal ganglia encephalitis with NMDAR-Abs positivity. The homogeneity in semeiology and radiography was analyzed and elucidated.