title: Anti-NMDA-receptor antibody detected in encephalitis, schizophrenia, and narcolepsy with psychotic features.
abstract: BACKGROUND
  Causative role of encephalitis in major psychotic features, dyskinesias (particularly orofacial), seizures, and autonomic and respiratory changes has been recently emphasized. These symptoms often occur in young females with ovarian teratomas and are frequently associated with serum and CSF autoantibodies to the NMDA receptor (NMDAR).
  
  
  METHODS
  The study included a total of 61 patients from age 15 to 61 and was carried out between January 1, 2005, and Dec 31, 2010. The patients were divided into the following three clinical groups for comparison. Group A; Patients with typical clinical characteristics of anti-NMDAR encephalitis. Group B; Patients with narcolepsy with severe psychosis. Group C; Patients with schizophrenia or schizo-affective disorders.
  
  
  RESULTS
  Ten out of 61 cases were anti-NMDAR antibody positive in typical encephalitis cases (group A: 3 of 5 cases) and cases in a broader range of psychiatric disorders including narcolepsy (group B: 3 of 5 cases) and schizophrenia (group C: 4 of 51 cases).
  
  
  CONCLUSIONS
  In addition to 3 typical cases, we found 7 cases with anti-NMDAR antibody associated with various psychotic and sleep symptoms, which lack any noticeable clinical signs of encephalitis (seizures and autonomic symptoms) throughout the course of the disease episodes; this result suggest that further discussion on the nosology and pathophysiology of autoimmune-mediated atypical psychosis and sleep disorders is required.
authors.affiliation: Akita University, Department of Neuropsychiatry, Akita, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Tsutsui
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanbayashi
authors.forename: Keiko
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shuken
authors.initials: S
authors.lastname: Boku
authors.forename: Wakako
authors.initials: W
authors.lastname: Ito
authors.forename: Jun
authors.initials: J
authors.lastname: Tokunaga
authors.forename: Akane
authors.initials: A
authors.lastname: Mori
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hishikawa
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shimizu
authors.forename: Seiji
authors.initials: S
authors.lastname: Nishino
mesh_terms: D000293:Adolescent; D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000097:blood / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D004660:Encephalitis / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000097:blood / Q000276:immunology*; D011618:Psychotic Disorders / Q000097:blood / Q000276:immunology*; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*; D012559:Schizophrenia / Q000097:blood / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D016194:Receptors, N-Methyl-D-Aspartate