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抗N-甲基-D-天冬氨酸受体脑炎:从心身医学角度看精神症状表现及诊断挑战

Anti-NMDA receptor encephalitis: psychiatric presentation and diagnostic challenges from psychosomatic medicine perspective.

作者信息

Gulyayeva Nataliya A, Massie Mary Jane, Duhamel Katherine N

机构信息

Fellow, Psycho Oncology, Department of Psychiatry & Behavioral Sciences at Memorial Hospital for Cancer and Allied Diseases, New York, New York.

Attending Psychiatrist, Department of Psychiatry & Behavioral Sciences at Memorial Hospital for Cancer and Allied Diseases, New York, New York.

出版信息

Palliat Support Care. 2014 Apr;12(2):159-63. doi: 10.1017/S1478951513000515.

Abstract

We describe two cases of confirmed anti-NMDA receptor encephalitis; one patient initially presented with a clinical picture that resembled delirium and later appeared to present with a conversion reaction and the second patient presented with a first psychotic break followed by the clinical picture of neuroleptic malignant syndrome with catatonia. Neither patient had a previous history of psychiatric illness or recreational drug use. These cases illustrate the diagnostic and treatment challenges associated with this neuropsychiatric condition and underscore the role of psychosomatic medicine psychiatrists in diagnosing anti-NMDA receptor encephalitis.

摘要

我们描述了两例确诊的抗N-甲基-D-天冬氨酸受体脑炎病例;一例患者最初表现出类似谵妄的临床症状,后来似乎出现了转换反应,另一例患者首次出现精神病性发作,随后出现伴有紧张症的抗精神病药恶性综合征的临床症状。两名患者既往均无精神疾病史或使用娱乐性药物史。这些病例说明了与这种神经精神疾病相关的诊断和治疗挑战,并强调了心身医学精神科医生在诊断抗N-甲基-D-天冬氨酸受体脑炎中的作用。

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