Int J Psychiatry Med. 2013;46(4):407-15. doi: 10.2190/PM.46.4.f.
Anti-N-methyl-D-aspartate receptor (NMDA-R) encephalitis, first characterized in 2005, is a neurological disease with prominent psychiatric features that frequently involves the consultation of psychiatrists. Since its discovery, the rate of diagnosis of new cases has increased rapidly and several epidemiological studies now confirm that NMDA-R encephalitis may be as common as many other prominent infectious etiologies of encephalitis. We describe a case of a young woman presenting initially with psychotic and mood symptoms who was found to have anti-NMDA-R encephalitis. We further provide details of her treatment and prolonged recovery process after hospital discharge with a review of the literature and discussion of the epidemiology, symptomology, diagnosis, and management of both the neurologic and psychiatric manifestations of this condition. Last, we contextualize the importance of anti-NMDA-R encephalitis for psychiatrists, highlighting the role for psychiatrists in establishing the initial diagnosis as well as in providing ongoing psychiatric care.
抗 N-甲基-D-天冬氨酸受体(NMDA-R)脑炎于 2005 年首次被描述,是一种具有明显精神特征的神经系统疾病,经常需要精神科医生的咨询。自发现以来,新病例的诊断率迅速上升,几项流行病学研究现在证实,NMDA-R 脑炎的发病率可能与许多其他常见的脑炎的明确感染病因一样高。我们描述了一位年轻女性的病例,她最初表现出精神病和情绪症状,被发现患有抗 NMDA-R 脑炎。我们进一步提供了她的治疗细节和出院后的长期康复过程,同时回顾了文献,并讨论了这种疾病的神经和精神表现的流行病学、症状学、诊断和管理。最后,我们将抗 NMDA-R 脑炎对精神科医生的重要性置于上下文中,强调了精神科医生在确立初始诊断以及提供持续精神科护理方面的作用。