From the Departments of Neuropsychology (RAH, LSB) and Physical Medicine & Rehabilitation (JV), Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.
Am J Phys Med Rehabil. 2019 Jul;98(7):529-535. doi: 10.1097/PHM.0000000000001087.
The aims of the current study were to characterize the demographic and clinical presentation of pediatric patients diagnosed with anti-N-methyl-D-aspartate receptor encephalitis who require inpatient rehabilitation, to examine early functional outcomes, and to investigate predictors of early recovery.
A retrospective chart review was conducted for 27 pediatric patients diagnosed with anti-N-methyl-D-aspartate receptor encephalitis who received intensive inpatient neurorehabilitation.
On average, patients were 10.6 yrs of age (range, 2-18 yrs) at the time of symptom onset. Average time to treatment from symptom onset was 27.2 days (range, 5-91 days). Patients displayed significant improvements between admission and discharge Functional Independence Measure for Children (WeeFIM) Developmental Functional Quotient (DFQ) scores across patients (P < 0.01). Mean Functional Independence Measure for Children Total Developmental Functional Quotient score at admission was 28.6 (range, 15.0-62.6) and at discharge was 54.3 (range, 14.2-91.9). Younger age at onset, seizures, and number of treatments received were associated with worse functional outcomes at discharge. Time to initiate treatment was not found to be associated with early functional outcomes.
Pediatric patients diagnosed with anti-N-methyl-D-aspartate receptor encephalitis displayed significant functional gains during inpatient rehabilitation, despite persistent functional deficits at discharge, suggesting the need for ongoing monitoring and intervention.
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to (1) Recognize the clinical presentation of anti-N-methyl-D-aspartate receptor encephalitis in pediatric patients, (2) Appreciate the role of rehabilitation in the care of the pediatric patient with anti-N-methyl-D-aspartate receptor encephalitis, and (3) Identify demographic and clinical variables that predict poor functional outcomes after rehabilitation in pediatric patients with anti-N-methyl-D-aspartate receptor encephalitis.
Advanced.
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
本研究旨在描述需要住院康复的抗 N-甲基-D-天冬氨酸受体脑炎患儿的人口统计学和临床特征，检查早期功能结局，并探讨早期恢复的预测因素。
对 27 名接受强化住院神经康复治疗的抗 N-甲基-D-天冬氨酸受体脑炎患儿进行回顾性病历审查。
患儿平均发病年龄为 10.6 岁（2-18 岁）。从症状发作到开始治疗的平均时间为 27.2 天（5-91 天）。患儿在入院和出院时的儿童功能独立性评定量表（WeeFIM）发育性功能商数（DFQ）评分均有显著改善（P＜0.01）。入院时儿童功能独立性评定量表总分发育性功能商数为 28.6（15.0-62.6），出院时为 54.3（14.2-91.9）。发病年龄较小、癫痫发作和接受的治疗次数与出院时的功能结局较差相关。开始治疗的时间与早期功能结局无关。
尽管出院时仍存在持续的功能缺陷，但诊断为抗 N-甲基-D-天冬氨酸受体脑炎的儿科患者在住院康复期间表现出显著的功能改善，表明需要持续监测和干预。
索取 CME 学分：在以下网址完成自我评估活动和评估：http://www.physiatry.org/JournalCME。CME 学习目标：完成本文后，读者应能够（1）识别儿科抗 N-甲基-D-天冬氨酸受体脑炎患者的临床表现，（2）了解康复在儿科抗 N-甲基-D-天冬氨酸受体脑炎患者治疗中的作用，（3）识别预测儿科抗 N-甲基-D-天冬氨酸受体脑炎患者康复后功能结局不良的人口统计学和临床变量。
高级。
学术物理治疗医师协会经继续教育认证委员会认可，为医生提供继续医学教育。学术物理治疗医师协会将这项基于期刊的 CME 活动指定为最多 1.0 项 AMA PRA 类别 1 学分（TM）。医生应仅声称与他们参与活动的程度相符的学分。
