Ten years after the publication of her memoir, “Brain on Fire,” former New York Post reporter Susannah Cahalan’s story is still helping lead to major medical breakthroughs and diagnoses of autoimmune encephalitis.
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Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an immune-mediated disorder that typically presents with rapid development of neuropsychiatric symptoms. As a potentially reversible cause of psychosis, there have been calls internationally for routine serological screening for anti-NMDAR…
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The prognosis for the sick child, who hadn’t responded to standard treatment, was dire. But a team of Rutgers physicians believed there might be hope despite the conventional wisdom against pursuing any further treatment.
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Lee et al.examine clinical characteristics and disease course, effectiveness of immunotherapy and prognostic factors in patients with seronegative autoimmune e…
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The post-acute evolution of the cognitive and psychiatric features of anti-N-methyl-D-aspartate
receptor (NMDAR) encephalitis has been poorly investigated so far. In recent work
published in Lancet Neurology, Guasp et al. report that the neuropsychiatric symptoms
of the post-acute phase mirror those observed in schizophrenia, although only patients
with anti-NMDAR encephalitis showed improvements of their symptoms.
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The majority of patients with anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis present with psychiatric symptoms and subsequently develop neurological features. However, isolated psychiatric episodes occur in <5% of affected individuals, less frequent at disease onset (<1%) compared to relapse (4%). We report the case of a previously healthy 24-year-old female who presented with psychotic symptoms and behavioral alterations. Despite therapy, she showed no improvement and subsequently developed catatonic features. While the ancillary tests were normal, the clinical warning signs raised the suspicion of anti-NMDAR encephalitis which we later confirmed. Given its strong association with underlying tumors, we screened the patient and found an ovarian teratoma. Once removed, the patient displayed a substantial improvement in the mental status. Besides being extremely rare, this case illustrates the need to maintain clinical suspicion of anti-NMDAR encephalitis even in the absence of neurological features or paraclinical anomalies.
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Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder sometimes accompanied by ovarian teratoma. However, the concept of encephalitis without anti-NMDAR antibodies successfully treated with ovarian teratoma resection and immunotherapy has not been established.
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AbstractBackground: Identifying the predictors for seizure outcome in autoimmune encephalitis (AE) and investigating how to prevent persistent seizures would have major clinical benefits effectively. Thus, we aimed to perform a systematic review and meta-analysis to examen seizure outcome-related…
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