Abstract Details

Title Does the NEOS Score Predict Outcomes in Pediatric Anti-NMDA Receptor Encephalitis Patients?

Topic Autoimmune Neurology

Presentation(s) Autoimmune Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 037

Objective

This study aims to validate the anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) One-Year Functional Status (NEOS) score for predicting functional outcomes in pediatric NMDARE.

Background

NMDARE is one of the most common causes of autoimmune encephalitis in pediatric patients. An accurate predictor of functional outcomes can be helpful in prognosis and management. The NEOS score was developed to identify factors associated with poor functional status at one-year in adult NMDARE patients. Here we test the NEOS score in pediatric NMDARE.

Design/Methods Retrospective review of patients at Children’s Healthcare of Atlanta diagnosed with NMDARE between 2010 and 2019 was performed. Demographic and clinical data were collected. The pediatric Modified Rankin Scale (mRS) was determined at one-year from onset, with scores ≥3 considered as poor functional status. NEOS score (0-5) was calculated with 1 point for each characteristic: ICU admission, treatment initiation 4 weeks after onset, lack of improvement at 4 weeks from treatment, abnormal MRI, and CSF WBC > 20. Descriptive statistics and the Cuzick nonparametric test for trend (Stata) were used to correlate NEOS scores with mRS at one-year.

Results

Twenty-five NMDARE patients with one-year follow-up were included. Mean age at diagnosis was 10.92 years (range 2-18 years). 72% were female and 64% were African American. 56% had good functional outcomes (mRS 0-2) at one-year. NEOS scores were significantly associated with the probability of a good functional outcome (100% for a NEOS 0, 58.3% for NEOS 1-2, 50% for NEOS 3, and 0% for NEOS 4, p-value=0.046).

Conclusions

NEOS scores are associated with functional outcomes in pediatric NMDARE, with 100% of NEOS 0 patients and 0% of NEOS 4 patients having good functional outcomes at one-year. A reliable, accurate predictor of functional outcomes could guide management and prognosis in pediatric NMDARE. Additional studies are needed to confirm the applicability of the NEOS score to pediatric NMDARE.

Authors/Disclosures
Leah Loerinc, MD PRESENTER	Miss Loerinc has nothing to disclose.
	No disclosure on file
Robyn Howarth	No disclosure on file
Grace Gombolay, MD, FAAN (Emory University/Children'S Healthcare of Atlanta)	The institution of Dr. Gombolay has received research support from CDC. The institution of Dr. Gombolay has received research support from NIH.

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