Psychosis associated with anti-N-methyl-D-aspartate receptor antibodies.
We describe the eighth case study of a female diagnosed with anti-N-methyl-D-aspartate receptor encephalitis without an identified tumor who presented with floridly psychotic symptoms following a 2-week prodromal phase with new-onset headaches and presyncopal episodes. While hospitalized, the patient had seizures, autonomic dysfunction, involuntary movements, and a decline in mental status. A subsequent assay was positive for anti-N-methyl-D-aspartate receptor receptor antibodies. In contrast to most reported cases, an initial trial with corticosteroids was therapeutically unsuccessful. Subsequent treatment with intravenous immunoglobulins, however, resulted in a prompt, robust clinical response and enabled the patient to be rapidly discharged from the hospital, with minimal neuropsychiatric sequelae.
Nasky
Kevin M
KM
Department of Psychiatry, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
Knittel
Douglas R
DR
Manos
Gail H
GH
D000328:Adult; D000906:Antibodies / Q000276:immunology*; D003937:Diagnosis, Differential; D004637:Emergency Services, Psychiatric; D004660:Encephalitis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000175:diagnosis / Q000276:immunology*; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*; D016896:Treatment Outcome
D000906:Antibodies; D016756:Immunoglobulins, Intravenous; D016194:Receptors, N-Methyl-D-Aspartate