青少年非副肿瘤性抗N-甲基-D-天冬氨酸受体脑炎所致急性精神病且恢复良好：一例报告
Teenager with acute psychosis due to non-paraneoplastic anti-N-methyl-d-aspartate receptor encephalitis with a successful recovery: A case report.
作者信息
Chamlagain Rajan, Shah Sangam, Thapa Sangharsha, Basnet Madan, Kandel Bipin, Paudel Basanta Sharma, Dhital Roman, Pokhrel Apil, Khanal Pitambar, Paudel Sandip
机构信息
Institute of Medicine, Tribhuvan University, Maharajgunj, 44600, Nepal.
Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
出版信息
Ann Med Surg (Lond). 2022 Sep 28;82:104790. doi: 10.1016/j.amsu.2022.104790. eCollection 2022 Oct.
INTRODUCTION
Anti NMDAR encephalitis is a neuropsychiatric syndromic disease caused by an immunological response. Acute behavioral changes, psychosis, and catatonia are common clinical manifestations, are seizures, amnesia, speech difficulties, dyskinesia, and autonomic dysregulation.
CASE PRESENTATION
We discuss the case of a 14-year-old girl who had psychotic symptoms and tested positive for anti-NMDAR antibodies.
DISCUSSION
Patients present with psychiatric symptoms such as delusions, hallucinations, agitation, changes in speech mania, disorganized thinking, catatonia, insomnia, and often seizures. Anti-NMDAR encephalitis should be suspected in teenage patient with acute psychotic symptoms and seizure episodes. A multidisciplinary treatment strategy is required.
CONCLUSION
The delayed treatment can lead to complications and delayed recovery complicating the disease process so multidisciplinary approach of treatment is necessary.
引言
抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎是一种由免疫反应引起的神经精神综合征疾病。急性行为改变、精神病和紧张症是常见临床表现，还有癫痫发作、失忆、言语困难、运动障碍和自主神经调节异常。
病例介绍
我们讨论了一名14岁女孩的病例，她出现了精神病症状且抗NMDAR抗体检测呈阳性。
讨论
患者表现出妄想、幻觉、躁动、言语躁狂改变、思维紊乱、紧张症、失眠等精神症状，且常伴有癫痫发作。对于出现急性精神病症状和癫痫发作的青少年患者，应怀疑抗NMDAR脑炎。需要采取多学科治疗策略。
结论
治疗延迟会导致并发症并使恢复延迟，使疾病过程复杂化，因此多学科治疗方法是必要的。
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