title: Anti-NMDA (a-NMDAR) receptor encephalitis related to acute consumption of metamphetamine: Relevance of differential diagnosis.
abstract: A 19-year-old male came to the Emergency Room of our hospital due to an episode of dystonic movements and disorientation 4 days after consuming methamphetamine, which evolved to a catatonic frank syndrome and eventually to status epilepticus. Definitive diagnosis was anti-NMDA receptor encephalitis, an acute inflammation of the limbic area of autoimmune origin in which early diagnosis and treatment are key elements for the final outcome. In this case, initial normal tests and previous methamphetamine poisoning delayed diagnosis, because inhaled-methamphetamine poisoning causes similar clinical symptoms to anti-NMDA receptor encephalitis. Methamphetamine poisoning may have caused an immune response in the patient, bringing on the progress of the pathology.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario de Basurto, Basurto, Vizcaya, España. Electronic address: olatziri@gmail.com.
authors.forename: O
authors.initials: O
authors.lastname: Iriondo
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario de Basurto, Basurto, Vizcaya, España.
authors.forename: J
authors.initials: J
authors.lastname: Zaldibar-Gerrikagoitia
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario de Basurto, Basurto, Vizcaya, España.
authors.forename: T
authors.initials: T
authors.lastname: Rodríguez
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario de Basurto, Basurto, Vizcaya, España.
authors.forename: J M
authors.initials: JM
authors.lastname: García
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario de Basurto, Basurto, Vizcaya, España.
authors.forename: L
authors.initials: L
authors.lastname: Aguilera
mesh_terms: D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D000927:Anticonvulsants / Q000627:therapeutic use; D001323:Autoantibodies / Q000134:cerebrospinal fluid; D001569:Benzodiazepines / Q000627:therapeutic use; D002389:Catatonia / Q000209:etiology / Q000628:therapy; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D003975:Diazepam / Q000627:therapeutic use; D004565:Electroconvulsive Therapy; D004630:Emergencies; D004828:Epilepsies, Partial / Q000139:chemically induced / Q000175:diagnosis; D006212:Hallucinations / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D000069544:Infectious Encephalitis / Q000175:diagnosis; D008297:Male; D008694:Methamphetamine / Q000506:poisoning*; D000077152:Olanzapine; D011041:Poisoning / Q000175:diagnosis / Q000276:immunology; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology; D013226:Status Epilepticus / Q000188:drug therapy / Q000209:etiology; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D001323:Autoantibodies; D016194:Receptors, N-Methyl-D-Aspartate; D001569:Benzodiazepines; D008694:Methamphetamine; D000077152:Olanzapine; D003975:Diazepam
keywords: Anti-N-methyl-D-aspartate receptor encephalitis; Central nervous system diseases; Encefalitis antirreceptor N-metil-D-aspartato; Encefalitis límbica; Enfermedades del Sistema nervioso central; Limbic encephalitis; Metanfetamina; Methamphetamine; Neuroimmunomodulation; Neuroinmunomodulación; Paranoid ddisorders; Trastornos paranoides