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Recommendations for the treatment of pediatric NMDAR antibody encephalitis

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neurons

NMDA receptor antibody encephalitis (NMDARE) is one of the most common autoimmune encephalitides characterized by a recognizable constellation of neurologic and psychiatric features alongside positive NMDAR antibodies.

In a new study published in Neuroimmunology and Neuroinflammation, authors, including Elizabeth Wells, M.D., vice president of Neuroscience and Behavioral Medicine Center at Children’s National Hospital, created a consensus recommendation for the treatment of pediatric NMDARE, which was pragmatic and relevant to a global community and could serve as a practical decision support tool for the clinician confronted with this rare and challenging condition.

The authors conclude that their recommendations for the management of pediatric NMDARE aim to standardize the treatment and provide practical guidance for clinicians, rather than absolute rules. A similar recommendation could be applicable to adult patients.

Read the full article in Neuroimmunology and Neuroinflammation.

Dr. Wells with patient

Elizabeth Wells, M.D., named Vice President of the Neuroscience and Behavioral Medicine Center

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Dr. Wells with patient

Elizabeth Wells, M.D., Vice President of the Neuroscience and Behavioral Medicine Center, interacting with patient.

Elizabeth Ann Molloy Wells, M.D., MHS, has been appointed to the role of Vice President of the Neuroscience and Behavioral Medicine Center at Children’s National Hospital. This new role has been created to further the growth of the Center, broaden and deepen the leadership structure and allow Children’s National to continue to deliver the highest level of care, education, safety and scholarship for our patients and families. “I joined Children’s National 15 years ago as a pediatric neurology resident because I thought it was the best place to train and develop in academic neurology, and I am so honored to serve as the Neuroscience Center Vice-President” said Dr. Wells.

Dr. Wells is a graduate of Harvard University and the George Washington University School of Medicine and Health Sciences. She holds a master’s in Health Science from the NIH-Duke Clinical Research Training Program. Dr. Wells completed her pediatrics and neurology training at Children’s National and has been on staff as a pediatric neurologist within the Brain Tumor Institute and the Division of Neurology for the past 10 years. In addition to caring for children with neurologic effects from cancer, Dr. Wells developed the multidisciplinary program in pediatric neuro-immunology. She serves on numerous national committees and receives national and international referrals for children with neuro-inflammatory disorders. She is a principal investigator for translational research studies and serves in a leadership role for the Clinical and Translational Science Institute and the District of Columbia Intellectual and Developmental Disabilities Research Center.  Dr. Wells has been director of Inpatient Neurology and the Neuroscience Medical Unit since 2015 and was elected president of the medical staff in July 2020.

During her time at Children’s National, Dr. Wells has become known for her communication skills, team building and tireless commitment to excellence. She will expand the Neuroscience Center’s work on quality and safety, medical informatics, diversity and inclusion and patient experience.  “I am especially excited to promote growth and visibility for developing and expanding Neuroscience programs. Doing so will enable us to serve more kids and spread knowledge and expertise for children affected by brain disorders and injuries. I also look forward to fostering our culture of teamwork” said Dr. Wells. “There is a sense of urgency in the Neuroscience and Behavioral Medicine Center to rapidly translate discoveries into answers for children and families, better treatments and tools to support strong and healthy lives.”

Acute flaccid myelitis concept illustration

Causes, diagnosis and management of acute flaccid myelitis

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Acute flaccid myelitis concept illustration

Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of AFM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. Children’s National Hospital was part of a multi-center study focused on AFM and published in The Lancet.

Children’s National authors include Elizabeth Wells, M.D., director of Inpatient Neurology; Jessica Carpenter, M.D., director of the Neonatal and Childhood Stroke Program and co-director of the Neurocritical Care Program; and Roberta DeBiasi, M.D., M.S., chief of the Division of Infectious Diseases.

This review describes the epidemiology, clinical features, course and outcomes of AFM to help to guide diagnosis, management and rehabilitation. Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral and immunological features of affected patients, host-virus interactions and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population.