Waaler Håkon Olafsen, Harbo Thomas
Ugeskr Laeger. 2021 Jan 18;183(3).
In this case report, a 27-year-old male presented at a department of neurology with postherpetic anti-N-methyl-d-aspartate (NMDA) receptor autoimmune encephalitis. The patient was psychotic and exhibited symptoms of akinetic and excited catatonia. He was mechanical restrained for a total of 46 days due to violent behaviour. He was treated with olanzapine and lorazepam up to 15 mg/day without effect on catatonic and behavioural symptoms. ECT was initiated, and the patient received a total of 16 treatments. He responded well to the treatment, and the violent behaviour resolved completely after the first treatment. ECT should be considered for catatonia in anti-NMDA-receptor autoimmune encephalitis.
在本病例报告中,一名27岁男性因疱疹后抗N-甲基-D-天冬氨酸(NMDA)受体自身免疫性脑炎就诊于神经内科。该患者存在精神病性症状,并表现出运动不能性激越型紧张症症状。因其暴力行为,他总共被机械约束了46天。他接受了奥氮平和劳拉西泮治疗,剂量高达每天15毫克,但对紧张症和行为症状均无效果。于是开始进行电休克治疗(ECT),该患者总共接受了16次治疗。他对治疗反应良好,首次治疗后暴力行为完全消失。对于抗NMDA受体自身免疫性脑炎所致的紧张症,应考虑采用电休克治疗。