Funayama Michitaka, Mizushima Jin, Takata Taketo, Koreki Akihiro, Mimura Masaru
a Department of Neuropsychiatry , Ashikaga Red Cross Hospital , Ashikaga , Japan.
b Department of Neuropsychiatry , Keio University School of Medicine , Tokyo , Japan.
Neurocase. 2018 Oct-Dec;24(5-6):255-258. doi: 10.1080/13554794.2019.1573260. Epub 2019 Jan 25.
Most patients with N-methyl-D-aspartate receptor (NMDAR) encephalitis initially present with psychiatric symptoms. Although a delayed diagnosis may lead to a poor outcome, psychiatric symptoms that could differentiate anti-NMDAR encephalitis from other psychoses have not been fully investigated. We evaluated two patients with anti-NMDAR encephalitis who were observed by psychiatrists from onset throughout the course of disease. Both patients exhibited disorientation, memory deficits, perceptual disturbances, hallucinations, and mood liability. Among those, altered perceptions were most prominent - in particular, altered time perceptions without disorganization syndrome. The information obtained for these patients may help clinicians differentiate anti-NMDAR encephalitis from other psychoses, e.g., schizophrenia.
大多数N-甲基-D-天冬氨酸受体(NMDAR)脑炎患者最初表现为精神症状。尽管延迟诊断可能导致不良后果,但尚未充分研究能够将抗NMDAR脑炎与其他精神病区分开来的精神症状。我们评估了两名抗NMDAR脑炎患者,从发病开始至病程全程均由精神科医生进行观察。两名患者均出现定向障碍、记忆缺陷、感知障碍、幻觉和情绪易变。其中,感知改变最为突出,尤其是无解体综合征的时间感知改变。从这些患者身上获得的信息可能有助于临床医生将抗NMDAR脑炎与其他精神病,如精神分裂症区分开来。