Table 2

Comparison of clinical and investigatory findings of patients with VGKC-complex and NMDAR encephalitis

NMDAR, this study (n=13)NMDAR antibody encephalitis (n=32)10VGKC-complex, this study (n=7)VGKC-complex encephalopathy in children (n=20)*
Age at onset (years)9.6 (range 1.83–17)14 (range 1.9–18)8.9 (range 6–15)8 (range 0.8–17)
Cognitive dysfunction13 (100%)28/32 (88%) Behavioural and personality change4 (57%)14 (70%)
Psychiatric problems10 (77%)N/A3 (43%)9 (45%)
Seizures10 (77%)23/30 (77%)7 (100%12 (60%)
Movement disorders7 (54%)26/31 (84%)0 (0%)7 (35%)
Fever at presentation4 (30%)48% prodrome noted4 (57%)8 (50%)
Neoplasm1(8%)8 (25%)0 (0%)1 (1%)
EEG abnormalities12 (92%)25/25 (100%)7 (100%)9/9 (100%)
MRI abnormalities (early)2 (15%)10/31(32%)4 (57%)9 (45%)
MRI abnormalities (late)4 (31%)N/A1 (14%)N/A
CSF abnormalities6 (46%)29/31 (94%)2 (29%)5 (25%)
Lymphocytosis3 (WCC 11–73)27/31 (WCC 5–200)2 (WCC 8–20)4 (WCC 6–25)
Oligoclonal bands3 (23%)5/6 (83%)0 (0%)N/A
PCR positive2/13 (15%)0 (0%)0 (0%)N/A
Immunotherapy received11 (77%)30/31 (97%)4 (57%)8 (50%)
Immunotherapy response10/11 (90%)22/30 (73%)4/4 (100%)9/12 (75%)
Ongoing problems9/13 (69%)20/31 (65%)5 (71%)12 (60%)
  • Patients with NMDAR encephalitis were more likely to have cognitive dysfunction and movement disorders. Seizures were seen more commonly in VGKC-complex encephalitis; these patients were less likely to receive immunotherapy. When comparing our cohort's clinical and paraclinical features to those in the reported literature, CSF abnormalities were seen less frequently as were the associated malignancies (not statistically significant).

  • *20 paediatric patients with encephalopathy associated with VGKC-complex antibodies were reported in seven manuscripts.11–17

  • CSF, cerebrospinal fluid; NMDAR, N-methyl-D-aspartate receptor; WCC, white cell count.