Nursing care of a pediatric patient with anti-NMDAR encephalitis complicated by secondary epilepsy: A case report.

Authors

Qionglei Huang, Luyao Wang

Published in

Medicine. Volume 105. Issue 38. Pages e50816. Sep 18, 2026.

Abstract

Autoimmune encephalitis in children often presents with neuropsychiatric symptoms and seizures and may progress to secondary epilepsy with prolonged functional impairment. Immunotherapy is the principal disease-modifying treatment, whereas comprehensive nursing care supports safety, complication prevention, rehabilitation, and continuity of care.
A 13-year-old girl presented with a 2-month history of intermittent dizziness and poor appetite, followed by abnormal behavior, mood disturbance, visual hallucinations, and seizures.
Based on characteristic neuropsychiatric manifestations, positive anti-N-methyl-d-aspartate receptor antibodies in cerebrospinal fluid and serum, and abnormal electroencephalographic findings, the patient was diagnosed with anti-NMDAR autoimmune encephalitis complicated by secondary epilepsy. Infectious encephalitis was initially considered.
The patient received first-line immunotherapy including high-dose corticosteroids and intravenous immunoglobulin, followed by plasma exchange and second-line rituximab therapy. Antiepileptic drugs and anti-infective treatments were administered as indicated. Whole-process nursing care was implemented across acute, intensive care, rehabilitation, and post-discharge phases.
After multidisciplinary treatment and nursing support, the patient regained clear consciousness with improved cognition and communication. Lower-limb muscle strength improved to grade 4/5, seizure frequency markedly decreased, and independent ambulation was achieved. At 3-month follow-up, no relapse was reported and the patient had returned to school.
This case highlights the importance of structured seizure safety management, strict infection prevention during immunotherapy, individualized rehabilitation guidance, and family-centered continuing care in pediatric anti-NMDAR autoimmune encephalitis complicated by secondary epilepsy.

PMID:
42760736
Bibliographic data and abstract were imported from PubMed on 19 Sep 2026.

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