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Pearls & Oy-sters: Electroconvulsive therapy in anti-NMDA receptor encephalitis

Pearls & Oy-sters: Electroconvulsive therapy in anti-NMDA receptor encephalitis RESIDENT & FELLOW Pearls & Oy-sters: SECTION Electroconvulsive therapy in anti-NMDA Section Editor Mitchell S.V. Elkind, MD, MS receptor encephalitis H.M.H. Braakman, MD CLINICAL PEARLS The clinical picture of anti- upper respiratory tract infection, he had persisting V.M.P. Moers-Hornikx, NMDA receptor (NMDAR) encephalitis is highly malaise and excessive sweating. Over a 3-week pe- characteristic; the presence of NMDAR antibodies riod, he developed derealization, intense anxiety, and MD B.M.G. Arts, MD, PhD confirms the diagnosis. eventually auditory hallucinations consisting of vari- R.M.M. Hupperts, MD, With its poor diagnostic criteria, encephalitis lethar- ous kinds of music. Neurologic examination and PhD gica (EL) is a descriptive term for a melting pot of symp- brain CT revealed no abnormalities, including no toms that likely represent multiple distinct disorders. brain tumor. The consultant psychiatrist diagnosed J. Nicolai, MD, PhD Sporadic EL is a diagnosis of exclusion, only to be psychosis with hallucinations of unknown origin. made after appropriate exclusion of anti-NMDAR Three days later, the patient reported insomnia, dis- Address correspondence and encephalitis and other (auto)immune phenomena. orientation, and suicidal thoughts. Neurologic exam- reprint requests to Dr. H. ination showed disorientation in place, memory Braakman, Department of INTRODUCTION NMDAR are ligand-gated cation disturbances, bradyphrenia, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurology Wolters Kluwer Health

Pearls & Oy-sters: Electroconvulsive therapy in anti-NMDA receptor encephalitis

Nicolai, J.
Neurology , Volume 75 (10) – Sep 1, 2010
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ISSN
0028-3878
eISSN
1526-632X
DOI
10.1212/WNL.0b013e3181f11dc1
pmid
20819992
Publisher site
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Abstract

RESIDENT & FELLOW Pearls & Oy-sters: SECTION Electroconvulsive therapy in anti-NMDA Section Editor Mitchell S.V. Elkind, MD, MS receptor encephalitis H.M.H. Braakman, MD CLINICAL PEARLS The clinical picture of anti- upper respiratory tract infection, he had persisting V.M.P. Moers-Hornikx, NMDA receptor (NMDAR) encephalitis is highly malaise and excessive sweating. Over a 3-week pe- characteristic; the presence of NMDAR antibodies riod, he developed derealization, intense anxiety, and MD B.M.G. Arts, MD, PhD confirms the diagnosis. eventually auditory hallucinations consisting of vari- R.M.M. Hupperts, MD, With its poor diagnostic criteria, encephalitis lethar- ous kinds of music. Neurologic examination and PhD gica (EL) is a descriptive term for a melting pot of symp- brain CT revealed no abnormalities, including no toms that likely represent multiple distinct disorders. brain tumor. The consultant psychiatrist diagnosed J. Nicolai, MD, PhD Sporadic EL is a diagnosis of exclusion, only to be psychosis with hallucinations of unknown origin. made after appropriate exclusion of anti-NMDAR Three days later, the patient reported insomnia, dis- Address correspondence and encephalitis and other (auto)immune phenomena. orientation, and suicidal thoughts. Neurologic exam- reprint requests to Dr. H. ination showed disorientation in place, memory Braakman, Department of INTRODUCTION NMDAR are ligand-gated cation disturbances, bradyphrenia,

Journal

Neurology – Wolters Kluwer Health

Published: Sep 1, 2010

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