Abstract Details

Title Population-based Incidence Estimate of Anti-NMDA Receptor Encephalitis in New York City

Topic Autoimmune Neurology

Presentation(s) S39 - Autoimmune and Paraneoplastic Neurological Disorders: Clinical Characteristics and Diagnosis (2:00 PM-2:12 PM)

Poster/Presentation
Number 006

Objective

To derive a population-based estimate of anti-NMDA receptor encephalitis (anti-NMDARE) incidence in New York City.

Background Anti-NMDARE is one of the most common and well-described forms of autoimmune encephalitis, however, few studies have assessed its overall incidence.

Design/Methods Cases were identified from The Rare Epilepsy of New York City (RENYC) database, which includes medical records for all patients with a visit associated with ICD-9 code 345.x (epilepsy), 779.0 (neonatal convulsions), or 780.39 (convulsions) from five academic medical centers in Manhattan and the Bronx between 2010–2014. This database was queried for the search term “NMDA,” and identified cases were reviewed to confirm that consensus criteria were met for definite diagnosis of anti-NMDARE. Those who lived in either Manhattan or the Bronx and who received their initial care within the study period were included in analyses. For incidence calculations, borough populations for each study year were obtained from city census data. It was anticipated that this search strategy may have resulted in the following potentially missed cases: those who did not have seizures (per prior literature, range 23-32%) and those who may never have received care at a study site hospital (per assessment of all hospital bed sizes in each borough, up to 22%).

Results

38 individuals with anti-NMDARE were identified, of whom 15 met inclusion criteria. Nine of 15 (60%) resided in Manhattan and six (40%) in the Bronx. Median age at symptom onset was 21 years (range 2-41 years). Three of 15 (20%) received care at multiple study site hospitals. Accounting for potentially missing cases yielded an overall incidence estimate of 0.5-0.8/100,000 new cases per year.

Conclusions

This study provides a population-based estimate of anti-NMDARE incidence in NYC. Understanding the demographic and clinical characteristics of individuals with anti-NMDARE in this large, diverse city will enable the future design of diagnostic/management tools and interventional studies.

Authors/Disclosures
Anusha Yeshokumar, MD (Icahn School of Medicine at Mount Sinai) PRESENTER	Dr. Yeshokumar has nothing to disclose.
	No disclosure on file
Parul Agarwal	Parul Agarwal has nothing to disclose.
Kiran Thakur, MD, FAAN (Columbia University College of Physicians and Surgeons)	Dr. Thakur has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Delve Bio. The institution of Dr. Thakur has received research support from Center for Disease Control and Prevention.
Natasha Basma	No disclosure on file
Mary Claire Tuohy	Ms. Tuohy has nothing to disclose.
	No disclosure on file
	No disclosure on file
Shelley S. Varnado, MD	No disclosure on file
Britany Klenofsky, MD	Dr. Klenofsky has nothing to disclose.
Elissa Yozawitz, MD	Dr. Yozawitz has nothing to disclose.
Nicole Luche	No disclosure on file
Dale C. Hesdorffer (Columbia University)	No disclosure on file
Aaron L. Nelson, MD, FAAN (NYU Langone Health)	Dr. Nelson has nothing to disclose.
Steven M. Wolf, MD (Pediatric Neurology Boston Children's He)	Dr. Wolf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Assertio. Dr. Wolf has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for LivaNova. Dr. Wolf has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurilis. Dr. Wolf has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB. Dr. Wolf has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for MOnteris . Dr. Wolf has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Marinus . The institution of Dr. Wolf has received research support from Neuropace. The institution of Dr. Wolf has received research support from Eisai. The institution of Dr. Wolf has received research support from Aguestive. The institution of Dr. Wolf has received research support from Neurilis . The institution of Dr. Wolf has received research support from UCB. The institution of Dr. Wolf has received research support from SKLife . The institution of Dr. Wolf has received research support from Longboard . The institution of Dr. Wolf has received research support from Takeda. The institution of Dr. Wolf has received research support from biohaven. The institution of Dr. Wolf has received research support from Assertio. Dr. Wolf has received intellectual property interests from a discovery or technology relating to health care. Dr. Wolf has received publishing royalties from a publication relating to health care.
Patricia E. McGoldrick, NP	No disclosure on file
Zachary Grinspan, MD	Dr. Grinspan has received personal compensation for serving as an employee of Weill Cornell Medicine. Dr. Grinspan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alpha Insights. Dr. Grinspan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biopharma LTD (South Korea). Dr. Grinspan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Encoded Therapeutics. The institution of Dr. Grinspan has received research support from SLC6A1 Connect. The institution of Dr. Grinspan has received research support from STXBP1 Foundation. The institution of Dr. Grinspan has received research support from Clara Inspired. The institution of Dr. Grinspan has received research support from Amgen. The institution of Dr. Grinspan has received research support from NINDS. Dr. Grinspan has received intellectual property interests from a discovery or technology relating to health care.
Nathalie Jette, MD, MSc, FRCPC, FAAN (University of Calgary)	Dr. Jette has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ILAE Epilepsia. The institution of Dr. Jette has received research support from NIH. The institution of Dr. Jette has received research support from AES.

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