Abstract

LANDA CONTRERAS, Ernesto; ALVITES AHUMADA, María del Pilar; FORTES ALVAREZ, José Luis  and  PEREZ LOPEZ, María de los Desamparados. Psychosis and anti-NMDA receptor encephalitis: a case report and literature review. Rev Clin Med Fam [online]. 2015, vol.8, n.1, pp.75-78. ISSN 2386-8201.  https://dx.doi.org/10.4321/S1699-695X2015000100011.

A 29-year-old female patient was hospitalized for behavioral disturbances, disorientation, and tonic-clonic seizures. The evolution was torpid, presenting symptoms ranging from confusion, soliloquies, unmotivated laughter, involuntary movements, psychotic symptoms, to mutism and stupor. Multiple analysis (uroporphyrins, coproporphyrins, zinc, ceruloplasmin), cultures, serology (HIV, Brucella, Cytomegalovirus, etc.), brain scan and magnetic resonance were carried out, with negative/normal results. The cerebrospinal fluid (CSF) showed lymphocytic pleocytosis. Antibodies for paraneoplastic disorders (anti-Hu, anti-Yo, anti-Ri, anti-CV2, amphyphysin, anti-Tr and anti-calcium channels) were negative, except the anti-NMDA antibodies (positive in CSF). Gynaecological ultrasound scan showed an increased ovary size. The final diagnosis was anti-NMDA receptor encephalitis (Paraneoplasic limbic encephalitis). Its autoimmune mechanism could provide an autoimmune model to explain psychotic symptoms.

Keywords : Anti-N-Methyl-D-Aspartate Receptor Encephalitis; Limbic Encephalitis; Antibodies.

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