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Anti-NMDA Receptor Encephalitis — History and Physical Exam — Clinical Pathway: Inpatient

Anti-NMDA Receptor Encephalitis Clinical Pathway — Inpatient

History and Physical Exam

Importance of Reassessment

  • Children with anti-NMDARE may change quickly.
  • Monitor for fluctuations in mental status, vital signs, and changes in the neurological examination.

History

Systemic
  • Prodrome of fever
  • Fatigue
Neurologic
  • Headaches
  • Abnormal movements
    • Particularly facial dyskinesias and choreiform movements
  • Mental status change
    • Decreased responsiveness
    • Change in consciousness
    • Changes to thinking/memory
  • Seizures
Psychiatry
  • Behavior concerns
  • Hallucinations
  • Mood changes
  • Psychosis
Infectious Disease Symptoms suggestive of respiratory or GI illness

Physical Examination

General
Neurologic
  • Altered mental status
  • Changes to muscle tone
  • Abnormal movements
    • Facial dyskinesias
    • Chorea
  • Increased deep tendon reflexes
  • Coordination deficits
    • Slowed rapid alternating movements
    • Ataxia
Respiratory Hypoventilation

 

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