In:
Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 92, No. 3 ( 2019-01-15), p. e244-e252
Abstract:
To construct a grading score that predicts neurologic function 1 year after diagnosis of anti-NMDA receptor (NMDAR) encephalitis. Methods Three hundred eighty-two patients with detailed information and functional status at 1 year were studied. Factors associated with poor status (defined as modified Rankin Scale score ≥3) were identified and incorporated into a multivariate logistic regression model. This model was used to develop a 5-point prediction score, termed the anti-NMDAR Encephalitis One-Year Functional Status (NEOS) score. Results Intensive care unit admission ( p 〈 0.001), treatment delay 〉 4 weeks ( p = 0.012), lack of clinical improvement within 4 weeks ( p 〈 0.001), movement disorder ( p = 0.001), central hypoventilation ( p 〈 0.001), elevated CSF white blood cell count ( p 〈 0.001), elevated CSF protein level ( p = 0.027), and abnormal MRI ( p = 0.002) were associated with 1-year functional status in univariate analysis. Intensive care unit admission, treatment delay 〉 4 weeks, lack of clinical improvement within 4 weeks, abnormal MRI, and CSF white blood cell count 〉 20 cells/μL were independent predictors for outcome in multivariate regression modeling. These 5 variables were assigned 1 point each to create the NEOS score. NEOS score strongly associated with the probability of poor functional status at 1 year (3% for 0 or 1 point to 69% for 4 or 5 points, p 〈 0.001). Conclusions The NEOS score accurately predicts 1-year functional status in patients with anti-NMDAR encephalitis. This score could help estimate the clinical course following diagnosis and may aid in identifying patients who could benefit from novel therapies.
Type of Medium:
Online Resource
ISSN:
0028-3878
,
1526-632X
DOI:
10.1212/WNL.0000000000006783
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
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