An unusual case of acute psychosis in an adolescent

Anti-N-methyl-D-aspartate receptor (NMDA-R) encephalitis is a severe form of encephalitis that has been identified within the context of acute neuropsychiatric manifestations. We report the case of an 18-year-old adolescent referred for a first episode of acute psychosis. The clinical picture rapidl...

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Bibliographic Details
Published in:Acta clinica belgica (English ed. Online) 2013-03, Vol.68 (2), p.138-139
Main Authors: Verfaillie, L, Bissay, V, Vanderbruggen, N, Van Eetvelde, E, Honoré, P M, Spapen, H
Format: Article
Language:English
Subjects:
Adolescent
Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications
Anti-N-Methyl-D-Aspartate Receptor Encephalitis - therapy
Blood pressure
Consciousness
Cyclophosphamide - therapeutic use
Diagnosis, Differential
Disease
Female
Humans
Immunosuppressive Agents - therapeutic use
Medical treatment
Metabolic disorders
Methylprednisolone - therapeutic use
NMR
Nuclear magnetic resonance
Patients
Plasma Exchange
Psychosis
Psychotic Disorders - etiology
Psychotic Disorders - therapy
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Summary:Anti-N-methyl-D-aspartate receptor (NMDA-R) encephalitis is a severe form of encephalitis that has been identified within the context of acute neuropsychiatric manifestations. We report the case of an 18-year-old adolescent referred for a first episode of acute psychosis. The clinical picture rapidly deteriorated to a state of catatonia, decreased consciousness and autonomic instability. Detection of highly positive anti-NMDA-R antibodies confirmed the diagnosis of anti-NMDA-R encephalitis. Immunosuppressive treatment and repeated plasma exchange resulted in slow recovery. The literature on diagnosis and treatment of this specific type of encephalitis is reviewed.
ISSN:1784-3286
2295-3337
DOI:10.2143/ACB.3252