TELANGANA JOURNAL OF PSYCHIATRY

TELANGANA JOURNAL OF PSYCHIATRY

Official Journal of Indian Psychiatric Society - Telangana State Branch

Contact no: +91-9390048686
Email: editoroftjp@gmail.com, drpingali@gmail.com

TELANGANA JOURNAL OF PSYCHIATRY

TJP. 2017 Volume 3 : Issue 1

Anti-NMDA receptor encephalitis presenting as an acute psychotic episode

Kamelendranath Choudary Pamulapati, Philip Kumar Boyanapalli

Abstract

Anti-NMDA receptor (NMDAR) encephalitis is a autoimmune disorder with prominent psychiatric symptoms. Patients usually present with acute behavioural change, psychosis, catatonic symptoms, memory deficits, seizures, dyskinesia, and autonomic instability.
We describe a 28 yrs old female patient who had previous 2 brief episodes of psychosis and has now again presented with psychosis but then clinical condition gradually worsened and she developed dyskinesia, catatonic symptoms and seizures. Though her routine blood work, brain imaging was normal, a confirmative diagnosis of NMDAR encephalitis was made by positive CSF studies. Patient was treated with methylprednisolone and plasmapheresis to which she showed response. This case illustrates the importance of considering NMDA R encephalitis as a differential diagnosis especially in young female with neuropsychiatric symptoms and progressive disturbance of consciousness, and associated involuntary movements, since prognosis depends on early recognition and treatment.




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