Dept. of Neurology, Dept. of Psychiatry, Dept. of Medicine, Saint Vincent's Hospital and Medical Centers, NY, NY Dept. of Neurology, NY-Presbyterian Hospital, Weill-Cornell Medical Center, NY, NY Correspondence: Nitin K. Sethi, M.D., Comprehensive Epilepsy Center, NY Presbyterian Hospital, Weill Cornell Medical Center e-mail: sethinitinmd{at}hotmail.com To the Editor: Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is a treatable paraneoplastic encephalitis that has been increasingly reported in predominantly young women harboring an ovarian teratoma. It usually presents with a combination of neuropsychiatric symptoms. This autoimmune disorder is likely mediated by antibodies against the NR1 subunit of the receptor. Since typical presentation is with acute psychotic symptomatology, these patients may initially present to the psychiatric service. Thus, a delay in diagnosis and treatment can occur unless a high index of clinical suspicion is maintained. The authors present here an unusual case of anti-NMDA-receptor encephalitis in a 52-year-old man who had a prolonged psychiatric course before seizure activity and autonomic instability was noted. Our case adds to the existing literature and emphasizes that anti-NMDA-receptor encephalitis can be seen in a wide spectrum of patients and should be included in the differential diagnosis for all patients presenting with acute onset of psychosis. Encephalitis in healthy individuals
An Unusual Case of Anti-NMDA-Receptor Encephalitis in the Psychiatry Inpatient Unit
Abstract
Dept. of Neurology, Dept. of Psychiatry, Dept. of Medicine, Saint Vincent's Hospital and Medical Centers, NY, NY Dept. of Neurology, NY-Presbyterian Hospital, Weill-Cornell Medical Center, NY, NY Correspondence: Nitin K. Sethi, M.D., Comprehensive Epilepsy Center, NY Presbyterian Hospital, Weill Cornell Medical Center e-mail: sethinitinmd{at}hotmail.com To the Editor: Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is a treatable paraneoplastic encephalitis that has been increasingly reported in predominantly young women harboring an ovarian teratoma. It usually presents with a combination of neuropsychiatric symptoms. This autoimmune disorder is likely mediated by antibodies against the NR1 subunit of the receptor. Since typical presentation is with acute psychotic symptomatology, these patients may initially present to the psychiatric service. Thus, a delay in diagnosis and treatment can occur unless a high index of clinical suspicion is maintained. The authors present here an unusual case of anti-NMDA-receptor encephalitis in a 52-year-old man who had a prolonged psychiatric course before seizure activity and autonomic instability was noted. Our case adds to the existing literature and emphasizes that anti-NMDA-receptor encephalitis can be seen in a wide spectrum of patients and should be included in the differential diagnosis for all patients presenting with acute onset of psychosis. Encephalitis in healthy individualsPreview Only. This article cannot be rented because we do not currently have permission from the publisher.
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An Unusual Case of Anti-NMDA-Receptor Encephalitis in the Psychiatry Inpatient Unit
Torgovnick, Josh; Izzo, Philip; Arsura, Edward; Sethi, Nitin K; Amrami, Binyamin; Martone, Louis
Follow Journal of Neuropsychiatry & Clinical Neurosciences
, Volume 23 (3): E8
American Psychiatric Publishing, Inc (Journal) – Aug 1, 2011
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