Anti-NMDA receptor encephalitis: an important differential diagnosis in psychosis

We present four cases of confirmed anti-NMDA receptor encephalitis; three presented initially with serious psychiatric symptoms and the other developed significant psychiatric symptoms during the initial phase of illness. Brain biopsy findings of one patient are also described. Psychiatrists should...

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Veröffentlicht in:	British journal of psychiatry 2011-12, Vol.199 (6), p.508-509
Hauptverfasser:	Barry, Helen, Hardiman, Orla, Healy, Daniel G., Keogan, Mary, Moroney, Joan, Molnar, Peter P., Cotter, David R., Murphy, Kieran C.
Format:	Artikel
Sprache:	eng
Schlagworte:	Adult Antagonist drugs Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnosis Anti-N-Methyl-D-Aspartate Receptor Encephalitis - psychology Anti-N-Methyl-D-Aspartate Receptor Encephalitis - therapy Antipsychotic Agents - therapeutic use Autoantibodies - blood Biopsy Brain Brain - pathology Catatonia Convulsions & seizures Delusions - complications Diagnosis, Differential Differential diagnosis Electroencephalography Encephalitis Female Glutamic acid receptors (ionotropic) Humans Immunoglobulins Immunoglobulins, Intravenous - therapeutic use Immunosuppressive Agents - administration & dosage Immunosuppressive Agents - therapeutic use Immunotherapy - methods Lymphocytes Lymphocytosis - cerebrospinal fluid Medical diagnosis Mycophenolic Acid - administration & dosage Mycophenolic Acid - analogs & derivatives Mycophenolic Acid - therapeutic use N-Methyl-D-aspartic acid receptors Ovarian Cysts - complications Ovarian Cysts - diagnostic imaging Ovarian Cysts - surgery Plasmapheresis Psychiatric disorders Psychiatric symptoms Psychiatrists Psychiatry Psychoses Psychosis Psychotic Disorders - diagnosis Psychotic Disorders - drug therapy Psychotic Disorders - immunology Psychotropic drugs Receptors, N-Methyl-D-Aspartate - immunology Recovery of Function Recurrence Seizures Seizures - complications Seizures - diagnosis Short report Steroids Steroids - therapeutic use Symptoms Ultrasonography Young Adult
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Zusammenfassung:	We present four cases of confirmed anti-NMDA receptor encephalitis; three presented initially with serious psychiatric symptoms and the other developed significant psychiatric symptoms during the initial phase of illness. Brain biopsy findings of one patient are also described. Psychiatrists should consider anti-NMDA receptor encephalitis in patients presenting with psychosis and additional features of dyskinesias, seizures and catatonia, particularly where there is no previous history of psychiatric disorder.
ISSN:	0007-1250 1472-1465
DOI:	10.1192/bjp.bp.111.092197