Inpatient Pathway for Evaluation and Treatment of Children
with Anti-NMDA Receptor Encephalitis (Anti-NMDARE)

Goals and Metrics
Child with Suspected Anti-NMDARE
Criteria for Suspected anti-NMDARE
  1. Rapid onset, < 3 mos, of at least 4 of the 6 following major groups of symptoms:
    1. Abnormal psychiatric behavior or cognitive dysfunction
    2. Speech dysfunction
    3. Seizures
    4. Movement disorder, dyskinesias, or rigidity/abnormal postures
    5. Decreased level of consciousness
    6. Autonomic dysfunction or central hypoventilation
  2. At least 1 of the following laboratory results:
    • Abnormal EEG with focal or diffuse slow or disorganized activity, epileptic activity, or extreme delta brush
    • CSF with pleocytosis or oligoclonal bands
  3. Diagnosis Confirmed
    When anti-NMDA receptor antibodies are present

Consult Multidisciplinary Care Team

Children with anti-NMDARE present with a wide array of symptoms and severity and require the expertise of a multidisciplinary team to optimize treatment, symptom management, recovery strategies. This multidisciplinary team includes clinicians from the following areas:

  • Neurology
  • Physical Medicine and Rehabilitation
  • Behavioral Health
  • Speech Therapy
  • Occupational Therapy
  • Physical Therapy
  • Neuropsychology
  • Social Work
  • Child Life
  • Board Certified Behavioral Analyst
Diagnostic Testing
Consult Neurology to review testing
(Serum, CSF, Brain MRI, EEG)
Management
Screen for Malignancy
Testicular/ovarian ultrasound, MRI pelvis
Discharge Planning

Posted: January 2023
Authors: S. Hopkins, MD; B. Banwell, MD; J. Mcguire, MD; M. Kirschen, MD; R. Prasad, MD; M. Mircetic, MD; L. Simon, MD; B. Blowey, PharmD; D. Deike, MD; A. Colin, CCC-SLP; C. Black PhD;
K. Young, CRNP; P. DiDonato, RN