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Anti-NMDA receptor encephalitis: a cause of acute psychosis and catatonia.
J Psychiatr Pract. 2013 Mar; 19(2):157-61.JP

Abstract

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a newly described form of encephalitis associated with prominent psychiatric symptoms at onset. Recognition of the symptom complex is the key to diagnosis. Most patients with anti-NMDAR encephalitis develop a multistage illness that progresses from initial psychiatric symptoms to memory disturbance, seizures, dyskinesia, and catatonia. Psychiatric manifestations include anxiety, mania, social withdrawal, and psychosis (i.e., delusions, hallucinations, disorganized behavior). The disorder is more common in females (80%), in approximately half of whom it is associated with an underlying ovarian teratoma. Treatment involves immunosuppression, with steroids and intravenous immunoglobulin considered first line. The disorder is particularly relevant to psychiatrists, because most patients are initially seen by psychiatric services. Psychiatrists should consider anti-NMDAR encephalitis in patients presenting with psychosis as well as dyskinesia, seizures, and/or catatonia, especially if there is no history of a psychiatric disorder. We present the case of a 37-year-old woman who demonstrated many of the key clinical features of this potentially treatable disorder.

Authors+Show Affiliations

Department of Neurology, Cork University Hospital, Cork, Ireland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

23507817

Citation

Ryan, Stephen A., et al. "Anti-NMDA Receptor Encephalitis: a Cause of Acute Psychosis and Catatonia." Journal of Psychiatric Practice, vol. 19, no. 2, 2013, pp. 157-61.
Ryan SA, Costello DJ, Cassidy EM, et al. Anti-NMDA receptor encephalitis: a cause of acute psychosis and catatonia. J Psychiatr Pract. 2013;19(2):157-61.
Ryan, S. A., Costello, D. J., Cassidy, E. M., Brown, G., Harrington, H. J., & Markx, S. (2013). Anti-NMDA receptor encephalitis: a cause of acute psychosis and catatonia. Journal of Psychiatric Practice, 19(2), 157-61. https://doi.org/10.1097/01.pra.0000428562.86705.cd
Ryan SA, et al. Anti-NMDA Receptor Encephalitis: a Cause of Acute Psychosis and Catatonia. J Psychiatr Pract. 2013;19(2):157-61. PubMed PMID: 23507817.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anti-NMDA receptor encephalitis: a cause of acute psychosis and catatonia. AU - Ryan,Stephen A, AU - Costello,Daniel J, AU - Cassidy,Eugene M, AU - Brown,Gemma, AU - Harrington,Hugh J, AU - Markx,Sander, PY - 2013/3/20/entrez PY - 2013/3/20/pubmed PY - 2013/9/14/medline SP - 157 EP - 61 JF - Journal of psychiatric practice JO - J Psychiatr Pract VL - 19 IS - 2 N2 - Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a newly described form of encephalitis associated with prominent psychiatric symptoms at onset. Recognition of the symptom complex is the key to diagnosis. Most patients with anti-NMDAR encephalitis develop a multistage illness that progresses from initial psychiatric symptoms to memory disturbance, seizures, dyskinesia, and catatonia. Psychiatric manifestations include anxiety, mania, social withdrawal, and psychosis (i.e., delusions, hallucinations, disorganized behavior). The disorder is more common in females (80%), in approximately half of whom it is associated with an underlying ovarian teratoma. Treatment involves immunosuppression, with steroids and intravenous immunoglobulin considered first line. The disorder is particularly relevant to psychiatrists, because most patients are initially seen by psychiatric services. Psychiatrists should consider anti-NMDAR encephalitis in patients presenting with psychosis as well as dyskinesia, seizures, and/or catatonia, especially if there is no history of a psychiatric disorder. We present the case of a 37-year-old woman who demonstrated many of the key clinical features of this potentially treatable disorder. SN - 1538-1145 UR - https://www.unboundmedicine.com/medline/citation/23507817/Anti_NMDA_receptor_encephalitis:_a_cause_of_acute_psychosis_and_catatonia_ L2 - http://dx.doi.org/10.1097/01.pra.0000428562.86705.cd DB - PRIME DP - Unbound Medicine ER -