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[Anti-NMDA-receptor encephalitis. An interdisciplinary clinical picture]
- Source :
- Der Nervenarzt. 81(4)
- Publication Year :
- 2010
-
Abstract
- Anti-NMDA-receptor encephalitis is a severe and considerably underdiagnosed form of encephalitis with characteristic clinical features including psychiatric symptoms, decreased levels of consciousness, hypoventilation, epileptic seizures, autonomic dysfunction and dyskinesias. Most patients are primarily seen by psychiatrists, often on the assumption of a drug-induced psychosis. Anti-NMDA-receptor encephalitis had initially been described in young women with ovarian teratoma, but is also common in women without tumour, in men and in children. The diagnosis is based on the characteristic clinical picture, supporting findings of brain MRI, electroencephalogram and cerebrospinal fluid (CSF), and the presence of highly specific autoantibodies directed against the NR1 subunit of NMDA-type glutamate receptors in the serum or CSF. In particular, anti-NMDA-receptor encephalitis must be excluded in patients with 'encephalitis of unknown cause'. In principle, the prognosis is favourable and recovery from symptoms can be expected even after prolonged intensive care treatment and mechanical ventilation. However, improvement correlates with prompt identification of the disorder, early immunotherapy and - in the case of a malignancy - with complete tumour removal. Patient care requires an interdisciplinary approach including neurologists, psychiatrists, paediatricians, oncologists and gynaecologists.
- Subjects :
- Male
Patient Care Team
Paraneoplastic Syndromes
Immunization, Passive
Electroencephalography
Plasmapheresis
Magnetic Resonance Imaging
Receptors, N-Methyl-D-Aspartate
Autoimmune Diseases
Diagnosis, Differential
Young Adult
Psychotic Disorders
Limbic Encephalitis
Limbic System
Encephalitis
Humans
Female
Interdisciplinary Communication
Cooperative Behavior
Child
Fluorescent Antibody Technique, Indirect
Immunosuppressive Agents
Autoantibodies
Subjects
Details
- Language :
- German
- ISSN :
- 14330407
- Volume :
- 81
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Der Nervenarzt
- Accession number :
- edsair.pmid..........ba061163f664bf9462cbfd831ad8cd64