Beattie, M., Goodfellow, J., Oto, M. and Krishnadas, R. (2022) Anti-NMDAR encephalitis for psychiatrists: the essentials. BJPsych Bulletin, 46(4), pp. 235-241. (doi: 10.1192/bjb.2021.35) (PMID:34075874) (PMCID:PMC9768510)
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Abstract
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis predominantly presents with psychiatric symptoms. Psychiatrists need to be alert to this diagnostic possibility, especially in female adolescents and young adults, as exemplified by the real (de-identified) case outlined below. Earlier diagnosis and immunotherapy improves long-term outcomes. Collaboration with neurology colleagues is essential for optimal care. ‘Red flags’ for autoimmune encephalitis and ‘diagnostic clues’ act as helpful aide memoires for this uncommon condition. The gold standard for testing is the detection of NMDAR antibodies in cerebrospinal fluid, but serum can be tested as a more accessible (but less reliable) preliminary step. The results of routine blood tests, magnetic resonance imaging of the head and electroencephalograms can be normal or show non-specific changes. Diagnostic criteria exist to define probable and definite cases. Immunotherapy for anti-NMDAR encephalitis is effective for many patients, but recovery is prolonged and relapses can occur.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Goodfellow, Mr John and Beattie, Dr Matthew and Krishnadas, Dr Rajeev |
Authors: | Beattie, M., Goodfellow, J., Oto, M., and Krishnadas, R. |
College/School: | College of Medical Veterinary and Life Sciences > School of Infection & Immunity College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience |
Journal Name: | BJPsych Bulletin |
Publisher: | Cambridge University Press |
ISSN: | 2056-4694 |
ISSN (Online): | 2056-4708 |
Published Online: | 02 June 2021 |
Copyright Holders: | Copyright © 2021 The Authors |
First Published: | First published in BJPsych Bulletin 46(4): 235-241 |
Publisher Policy: | Reproduced under a Creative Commons License |
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