Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal, Europa.
Consulta de Esquizofrenia Resistente, Hospital Júlio de Matos, Centro Hospitalar Psiquiátrico de Lisboa, Lisboa, Portugal, Europa .
CNS Spectr. 2020 Aug;25(4):475-492. doi: 10.1017/S1092852919001573. Epub 2019 Oct 30.
Anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis is a relatively recent autoimmune entity, as it was first described in 2007. Given that it is a condition with neuropsychiatric symptoms, its initial symptom is frequently psychiatric in nature. Hence, psychiatrists are often the first physicians to assess these patients and, as so, must recognize this type of encephalitis as a possible cause. Catatonia may be inaugural or develop throughout the course of the disease. Management of patients with anti-NMDAr encephalitis is based on etiologic treatment with immunotherapy and removal of the associated tumor, if any. However, these catatonic patients may have variable responses to etiologic treatment, sometimes with refractory catatonic symptoms, which attests to the necessary urgency to know how to manage these patients. In the clinical setting, physicians appear to be using guidelines originally created to the management of catatonia due to primary psychiatric conditions. In this literature review, catatonia was historically contextualized and anti-NMDAr encephalitis overall described. Finally, catatonia secondary to this type of encephalitis was discussed.
抗 N-甲基-D-天冬氨酸受体 (NMDAr) 脑炎是一种相对较新的自身免疫性疾病,它于 2007 年首次被描述。鉴于其具有神经精神症状,其初始症状通常具有精神性质。因此,精神科医生通常是评估这些患者的第一批医生,因此,他们必须将这种类型的脑炎视为一种可能的病因。紧张症可能是首发症状,也可能在疾病过程中发展。抗 NMDAr 脑炎患者的治疗基于病因治疗,包括免疫治疗和如果存在相关肿瘤则进行切除。然而,这些紧张症患者可能对病因治疗有不同的反应,有时会出现难治性紧张症症状,这证明了必须紧急了解如何管理这些患者。在临床环境中,医生似乎正在使用最初为原发性精神疾病的紧张症管理而制定的指南。在本次文献复习中,紧张症在历史上进行了背景化处理,同时还对整体抗 NMDAr 脑炎进行了描述。最后,还讨论了继发于这种类型脑炎的紧张症。