Kayser Matthew S, Dalmau Josep
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA ; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Spain.
Curr Psychiatry Rev. 2011;7(3):189-193. doi: 10.2174/157340011797183184.
Anti-NMDA receptor encephalitis is an autoimmune disorder in which antibodies attack NMDA (-methyl-D-aspartate)-type glutamate receptors at central neuronal synapses. Symptoms include a highly characteristic set of neurologic deficits, but also prominent psychiatric manifestations that often bring mental health professionals into the course of care. Distinct phases of illness have become increasingly appreciated, and include a range of psychotic symptoms early in the course of the disease followed by more severe fluctuations in consciousness with neurologic involvement, and ultimately protracted cognitive and behavioral deficits. Young women are most commonly impacted and an ovarian teratoma is sometimes associated with the syndrome. Patients respond well to immunotherapy, but psychiatric symptoms can be challenging to manage. We provide an up to date review of this disorder and highlight the role of psychiatry in diagnosis, symptomatology, and treatment.
抗N-甲基-D-天冬氨酸受体脑炎是一种自身免疫性疾病，抗体攻击中枢神经元突触处的N-甲基-D-天冬氨酸（NMDA）型谷氨酸受体。症状包括一系列高度特征性的神经功能缺损，还有突出的精神症状，这常常使心理健康专业人员参与到治疗过程中。疾病的不同阶段越来越受到重视，包括疾病早期的一系列精神病性症状，随后是意识更严重的波动并伴有神经受累，最终出现持久的认知和行为缺陷。年轻女性最常受到影响，有时卵巢畸胎瘤与该综合征有关。患者对免疫治疗反应良好，但精神症状可能难以处理。我们对这种疾病进行了最新综述，并强调了精神病学在诊断、症状学和治疗中的作用。
