Anti-NMDA receptor encephalitis presenting as an acute psychotic episode misdiagnosed as dissociative disorder: a case report

JA Clinical Reports
Yuichiro ShimoyamaToshiaki Minami

Abstract

In 2005, "anti-N-methyl-d-aspartate (NMDA) receptor encephalitis," a syndrome with prominent psychiatric symptoms, memory loss, decrease in level of consciousness, and central hypoventilation, was described in young women with ovarian teratomas and antibodies against an antigen highly expressed in the hippocampus. This report highlights the growing need for increased awareness among psychiatrists and other relevant medical professionals about this under-diagnosed disorder, which should be considered in differential diagnoses. A 19-year-old female with no psychiatric history presented to a district general hospital with acute psychosis, emotional lability, memory deficit, fluctuating behavioral changes such as wandering and babbling, and seizure. She was admitted to the hospital with a provisional diagnosis of dissociative disorder. Soon after admission, she developed aspiration pneumonia and was intubated for mechanical ventilation. She was transferred to our hospital for further assessment and admitted to the intensive care unit for ventilation. Laboratory test results were unremarkable, but her EEG showed non-specific slowing with no epileptiform activity, and brain computed tomography (CT) and MRI also showed no remarkable f...Continue Reading

References

Oct 26, 2010·Journal of Neurology·Michael S ZandiBelinda R Lennox
Dec 18, 2010·Lancet Neurology·Josep DalmauRita Balice-Gordon

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Citations

Jun 7, 2017·Journal of Clinical and Experimental Neuropsychology·Gemma L McKeonJames G Scott

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Methods Mentioned

BETA
sedation

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