BibTex format
@misc{Catto:2013,
author = {Catto, A and Hilton, C},
title = {Catching an NMDA-receptor encephalitis: clinical features to discriminate from other psychiatric syndromes},
type = {Poster},
year = {2013}
}
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RIS format (EndNote, RefMan)
TY - GEN
AB - Introduction:NMDA receptor encephalitis is a rare reversible cause of neuro-psychiatric disturbance. It frequently presents with characteristics which can resemble psychosis, catatonia and Neuroleptic Malignant Syndrome (NMS). We aim to highlight the difficulties of establishing a diagnosis of NMDAr encephalitis and how it might be distinguished from these other psychiatric syndromes. Methods:A recent case of a young woman is described with particular focus on neuropsychiatric symptomatology. We then report the results of targeted systematic literature review between 2005-2013 of papers comparing clinical features of catatonia or NMS to NMDA receptor encephalitis in an attempt to develop an aid for psychiatrists to differentiate these illnesses. Results:In the described case many of the key features of catatonia and NMS are displayed at various points during her illness before an eventual diagnosis of NMDAr encephalitis.The literature review reveals 10 papers and a total of 11 case reports linking NMS or catatonia to confirmed NMDAr encephalitis. Of 11 case reports of confirmed NMDAr encephalitis, 10/11 demonstrated psychotic features, 8/11 had concomitant catatonic features and 5/11 fever following exposure to antipsychotic medications suggesting NMS. Reported average time to diagnosis was 43 days. The features that might have raised early suspicion of NMDAr encephalitis included first episode of mental disturbance 11/11, acute deterioration 9/11, seizure-like movements (with or without epileptiform activity) 10/11, poor memory 7/11 and autonomic instability 6/11.Conclusion: NMDAr encephalitis can present with features suggestive of psychosis, psychiatric catatonia and NMS. A high index of suspicion is required for its diagnosis. We postulate that patients presenting with first episode psychosis who develop catatonic features, seizure-like movements or autonomic disturbance could be tested for NMDAr antibodies as part of their work up.
AU - Catto,A
AU - Hilton,C
PY - 2013///
TI - Catching an NMDA-receptor encephalitis: clinical features to discriminate from other psychiatric syndromes
ER -