Teenager with acute psychosis due to non-paraneoplastic anti-N-methyl-d-aspartate receptor encephalitis with a successful recovery: A case report. (October 2022)

• Record Type: Journal Article
• Authors: Chamlagain, Rajan; Shah, Sangam; Thapa, Sangharsha; Basnet, Madan; kandel, Bipin; Paudel, Basanta Sharma; Dhital, Roman; Pokhrel, Apil; Khanal, Pitambar; Paudel, Sandip
• Is Part Of: Annals of medicine and surgery. Volume 82(2022)
• Publication Date: 2022-10
• Subjects: Anti NMDAR encephalitis -- Anti NMDA receptor Encephalitis -- Autoimmune encephalitis; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104790
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Anti NMDAR encephalitis is a neuropsychiatric syndromic disease caused by an immunological response. Acute behavioral changes, psychosis, and catatonia are common clinical manifestations, are seizures, amnesia, speech difficulties, dyskinesia, and autonomic dysregulation. Case presentation: We discuss the case of a 14-year-old girl who had psychotic symptoms and tested positive for anti-NMDAR antibodies. Discussion: Patients present with psychiatric symptoms such as delusions, hallucinations, agitation, changes in speech mania, disorganized thinking, catatonia, insomnia, and often seizures. Anti-NMDAR encephalitis should be suspected in teenage patient with acute psychotic symptoms and seizure episodes. A multidisciplinary treatment strategy is required. Conclusion: The delayed treatment can lead to complications and delayed recovery complicating the disease process so multidisciplinary approach of treatment is necessary. Highlights: Acute psychotic symptoms with seizure episodes in adolescent patient should have a suspicion of anti-NMDAR encephalitis. The delayed treatment can lead to complications and delayed recovery complicating the disease process. Multidisciplinary approach of treatment is necessary.