Koolwal Arpit, Agrawal Supriya, Koolwal Ghanshyam Das, Saxena Kaveri, Daral Ankit
Department of Psychiatry, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
Department of Psychiatry, Subharti Medical College, Meerut, Uttar Pradesh, India.
Ann Indian Acad Neurol. 2020 Mar-Apr;23(2):225-227. doi: 10.4103/aian.AIAN_295_18. Epub 2020 Feb 25.
Anti-NMDAR encephalitis is an autoimmune encephalitis with a typical clinical progression. Patients can often present to psychiatric outpatient departments (OPDs) mimicking psychiatric illnesses. In this case series, we have described two cases of adolescent age group that were eventually diagnosed with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. They had presented to psychiatry OPD and were admitted to the psychiatry ward. Both cases had predominantly, although varied, psychiatric symptoms with a variable course, response to treatment and prognosis. We have tried to speculate if initial presentation in anti-NMDAR encephalitis can be suggestive or can predict response to treatment and prognosis in a patient. We advocate a high degree of suspicion for psychiatrists toward patients presenting acutely in the first episode of mania or psychosis, particularly in adolescent age group.
抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎是一种具有典型临床病程的自身免疫性脑炎。患者常以类似精神疾病的症状就诊于精神科门诊。在本病例系列中,我们描述了两例青少年患者,最终被诊断为抗N-甲基-D-天冬氨酸受体(抗NMDAR)脑炎。他们最初就诊于精神科门诊,随后被收入精神科病房。两例患者均以精神症状为主,虽症状各异,但病程、治疗反应及预后各不相同。我们试图推测抗NMDAR脑炎的初始表现是否具有提示作用,或者能否预测患者的治疗反应及预后。我们主张精神科医生对于首次急性发作躁狂或精神病的患者,尤其是青少年患者,要保持高度怀疑。