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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Friday, July 15, 2016

Anti-N-Methyl-D-Aspartate Receptor Encephalitis

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Lasoff D et al. West J Emerg Med. 2016 May; 17(3): 280–282.
"Anti-N-Methyl-D-Aspartate Receptor (NMDAR) Encephalitis is a novel disease discovered within the past 10 years. Antibodies directed at the NMDAR cause the patient to develop a characteristic syndrome of neuropsychiatric symptoms. Patients go on to develop autonomic dysregulation and often have prolonged hospitalizations and intensive care unit stays. There is little literature in the emergency medicine community regarding this disease process, so we report on a case we encountered in our emergency department to help raise awareness of this disease process.
Anti-NMDAR encephalitis carries a significant morbidity and mortality that is worsened by delays in diagnosis; it is underappreciated and unrecognized in the ED This case illustrates some common features of anti-NMDAR encephalitis: a patient with recent psychiatric symptoms who presents with a neurological complaint, a delay in diagnosis and a lengthy course of treatment. Although our patient fits the usual age range and had common presenting symptoms of behavioral changes and seizures, anti-NMDAR encephalitis is more common in women. Emergency physicians who encounter patients with new onset neurologic complaints preceded by psychiatric symptoms should consider anti-NMDAR encephalitis in the differential diagnosis as it may promote earlier treatment and improve outcomes."