Acute psychiatric illness in a young woman: an unusual form of encephalitis.
A 21-year-old woman was admitted to hospital with a diagnosis of acute psychotic mania, but developed, over approximately 6 weeks, seizures, delirium, catatonia, movement disorder and autonomic dysfunction. She was found to have antibodies to N-methyl-D-aspartate (NMDA) NR1-NR2 receptors in both serum and cerebrospinal fluid, consistent with anti-NMDA-receptor encephalitis, a severe, potentially lethal but treatment-responsive encephalitis often associated with ovarian tumour. With aggressive immunotherapy and bilateral oophorectomy, she recovered over a period of 14 months from her initial presentation. No ovarian tumour was identified.
Parratt
Kaitlyn L
KL
Department of Neurology, Royal Prince Alfred Hospital, Sydney, NSW. drksharp@bigpond.net.au
Allan
Martin
M
Lewis
Simon J G
SJ
Dalmau
Josep
J
Halmagyi
Gabor M
GM
Spies
Judith M
JM
D000208:Acute Disease; D000906:Antibodies / Q000097:blood / Q000134:cerebrospinal fluid; D001714:Bipolar Disorder / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004660:Encephalitis / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D000906:Antibodies; D016194:Receptors, N-Methyl-D-Aspartate