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- W2896739247 abstract "Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis, the most common type of autoimmune encephalitis, may present with neuropsychiatric symptoms. This case report describes a patient with anti-NMDA receptor encephalitis who presented with a clinical syndrome resembling catatonia. A 52-year-old woman was admitted to hospital with a 5-month history of progressive deterioration of verbal output, ambulation and urinary incontinence. She was diagnosed with bipolar disease in 2010 and started on lithium treatment. She had an episode of catatonic depression in 2010, a manic episode in 2012 and an episode of psychotic depression in 2014. She received electroconvulsive therapy (ECT) after depressive episodes in 2010 and 2014. She did not fully recover to baseline psychiatric status after these episodes. Five months prior to admission, she started developing apathy and ataxia and then became increasingly more apathetic. On admission, her neurologic examination revealed severe apathy and decreased responsiveness, her verbal output was limited to a few words. She was unable to stand and walk. She had bilateral increased muscle tone with waxy flexibility. Psychiatric consultation resulted in a suspected diagnosis of catatonic psychosis. MRI showed frontoparietal cortical atrophy. Electroencephalography (EEG) depicted irregular theta waves on both hemispheres. Cerebrospinal fluid (CSF) protein level was elevated (70.8 mg/dL), and anti-NMDA receptor antibodies were positive in the CSF. Detailed screening for malignancies remained negative. Intravenous methylprednisolone (1 gr/kg for 5 days) and intravenous immunoglobulin (0.4 g/kg) treatments were started. After immunosuppressive treatment, her mental status improved and verbal output increased. After 7 days of treatment she was able to sit and walk with assistance, her EEG became normalized. In patients with a clinical presentation resembling catatonic psychosis, the possibility of anti-NMDA encephalitis should be considered." @default.
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- W2896739247 date "2018-07-01" @default.
- W2896739247 modified "2023-10-18" @default.
- W2896739247 title "P4‐085: CATATONIA AS CLINICAL PRESENTATION OF ANTI‐N‐METHYL‐D‐ASPARTATE (ANTI‐NMDA) RECEPTOR ENCEPHALITIS" @default.
- W2896739247 doi "https://doi.org/10.1016/j.jalz.2018.06.2488" @default.
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