The Brain on Fire: A Case Study on Anti-NMDA Receptor Encephalitis
| 18. März 2019
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Article Category: research-article
Online veröffentlicht: 18. März 2019
Seitenbereich: 1 - 8
DOI: https://doi.org/10.21307/ajon-2017-014
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© 2019 Grissel B Crasto., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Clinical features noted in patients with Anti-NMDAR receptor encephalitis
| Focal neurological signs | Weakness in limbs, seizures, altered behaviour, memory loss, confusion |
| Psychiatric signs | Auditory, visual and olfactory hallucinations; irritability, agitation, aggression and violent behaviour; catatonia |
| Autonomic instability | Fever, tachycardia/bradycardia, hypotension/hypertension, hypoventilation |
Clinical presentations, treatments and outcome of cases seen at our hospital
| Case | Symptoms | Treatment | Adjunct therapies | Complications | Outcomes |
|---|---|---|---|---|---|
| Aphasia, posturing (rigid), myoclonus jerks, tonic-clonic seizures, opsoclonus, decreased level of consciousness, respiratory difficulties, loss of tone, agitation, aggression | Bilateral Oopherectomy | ECT, Methylprednisolone, IVIG, Rituximab, Tetrabenzene, Quetiapine, Haloperidol, Olanzapine, Ketamine and Cyclophosphamide | Intubation, ventilator associated pneumonia, bacteremia, status epilepticus, febrile neutropenia | Complex care rehab, discharged home | |
| Confusion, hallucinations, global aphasia, agnosia, prosopagnosia, memory deficits, posturing, myoclonus and seizures | Bilateral Oopherectomy | AEDs, Acyclovir, IVIG, plasmapheresis, methylprednisolone | Manic symptoms, psychosis (Psychiatry consulted for unresolved mania) | Repatriation, cognitive rehab, discharged home | |
| Brocca’s aphasia progressed to global aphasia, parasthesia in arms, generalized seizures, hallucinations, sensitivity to light and noise, agnosia, prosopagnosia, falling spells and wandering | Right Oopherectomy RRR | Methylprednisolone, IVIG | UTI, allergic reaction to methylprednisolon e (Psychiatry consulted for unresolved catatonia) | Cognitive rehab, discharged home |