Deest M, Eberlein C, Bleich S, Frieling H, Skripuletz T, Neyazi A
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Case Rep Psychiatry. 2021 Apr 23;2021:6687735. doi: 10.1155/2021/6687735. eCollection 2021.
Viral encephalitis often presents with severe illness, headache, fever, behavioral changes, altered level of consciousness, and focal neurologic deficits. One of the most feared kind of virus encephalitis is herpes simplex encephalitis; however, other central virus infections are also capable of presenting with psychiatric symptoms. Here, we report the case of a 22-year-old woman with first time visual and auditory hallucinations due to an acute enterovirus encephalitis with no cerebrospinal fluid abnormalities but a positive PCR result for enterovirus (ECHO). During treatment, the symptoms deteriorated, and she hat to be shifted to the sheltered ward because of imperative suicidal auditory hallucinations. Under treatment with risperidone and olanzapine, symptoms suddenly stopped and did not reoccur under subsequent reduction of the antipsychotic medication.
病毒性脑炎常表现为病情严重、头痛、发热、行为改变、意识水平改变及局灶性神经功能缺损。最令人恐惧的病毒性脑炎之一是单纯疱疹病毒性脑炎;然而,其他中枢性病毒感染也可能出现精神症状。在此,我们报告一例22岁女性病例,该患者因急性肠道病毒性脑炎首次出现视幻觉和听幻觉,脑脊液无异常,但肠道病毒(埃可病毒)聚合酶链反应结果呈阳性。治疗期间,症状恶化,由于迫切的自杀性听幻觉,她不得不转至庇护病房。在使用利培酮和奥氮平治疗后,症状突然消失,在随后减少抗精神病药物剂量时未再次出现。