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[抗N-甲基-D-天冬氨酸受体脑炎:精神科的一项重要鉴别诊断——病例报告。]

[Anti-N-methyl-D-aspartate receptor encephalitis, an essential differential diagnosis in psychiatry: a case report.].

作者信息

Treidl Lucas, Izadi Shahriar, Rießland-Seifert Angelika

机构信息

1. Psychiatrische Abteilung mit Zentrum für Psychotherapie und Psychosomatik, Sozialmedizinisches Zentrum Baumgartner Höhe, Otto Wagner Spital, Baumgartner Höhe 1, 1140, Wien, Österreich.

出版信息

Neuropsychiatr. 2019 Jun;33(2):107-110. doi: 10.1007/s40211-018-0296-8. Epub 2019 Jan 17.

Abstract

Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR encephalitis) is a rare and recently discovered disease. Affected patients are initially often referred to psychiatric departments due to prominent neuropsychiatric symptoms.We present the course of the illness of an 18-year-old female patient, who was primarily and for the first time admitted to the 1. Psychiatric Department of the Otto Wagner Hospital Vienna due to a psychotic disorder. With fluctuating clinical course, further diagnostics were performed and the patient was diagnosed with anti-NMDAR encephalitis.Anti-NMDAR encephalitis should especially be considered in young women, who suffer from a first-onset psychotic disorder in combination with neurological and vegetative symptoms.If suspected lumbar puncture is indicated. An interdisciplinary approach is indispensable for this disease and can be a challenge for psychiatrists in charge.Psychiatrists should consider encephalitis, autoimmune encephalitis in particular, as differential diagnosis in clinical practice and get more familiar with these complex conditions.

摘要

抗N-甲基-D-天冬氨酸受体脑炎(抗NMDAR脑炎)是一种罕见的、最近才发现的疾病。由于突出的神经精神症状,受影响的患者最初常常被转诊至精神科。我们报告了一名18岁女性患者的病程,该患者因精神障碍首次入住维也纳奥托·瓦格纳医院第一精神科。随着临床病程的波动,进行了进一步的诊断,患者被诊断为抗NMDAR脑炎。抗NMDAR脑炎尤其应在患有首发精神障碍并伴有神经和植物神经症状的年轻女性中予以考虑。如果怀疑,应进行腰椎穿刺。对于这种疾病,多学科方法是必不可少的,这对负责的精神科医生来说可能是一项挑战。精神科医生在临床实践中应将脑炎,尤其是自身免疫性脑炎,作为鉴别诊断,并更熟悉这些复杂病症。

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