Paraneoplastic Limbic Encephalitis Case Report In A Patient With Suspected Conversion Disorder
Introduction . Autoimmune encephalitis is a difficult-to-recognize, complex disease that can present with various neuropsychiatric symptoms. N-methyl-D-aspartate receptor (NMDA-r) and anti-leucine-rich glioma-inactivated 1 protein (LGI-1) subtypes of autoimmune encephalitis may present with psychia...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822003777/type/journal_article |
| _version_ | 1797617288731426816 |
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| author | A.N. Duran Öztürk O. Sahmelikoglu Onur N. Karamustafalioglu |
| author_facet | A.N. Duran Öztürk O. Sahmelikoglu Onur N. Karamustafalioglu |
| author_sort | A.N. Duran Öztürk |
| collection | DOAJ |
| description |
Introduction
. Autoimmune encephalitis is a difficult-to-recognize, complex disease that can present with various neuropsychiatric symptoms. N-methyl-D-aspartate receptor (NMDA-r) and anti-leucine-rich glioma-inactivated 1 protein (LGI-1) subtypes of autoimmune encephalitis may present with psychiatric symptoms.
Objectives
We would like to present an autoimmune encephalitis case that can be confused with conversion disorder.
Methods
A 54-year-old, female patient started to have forgetfulness ten months ago, and convulsions started five months ago. The patient had disorganized behaviors and contractions in the extremities. Diffusion MRI and brain CT images were normal. The patient had low blood sodium level. In the follow-up, her orientation was impaired and she could hardly make eye contact. As the patient’s contractions were evaluated as conversion in the first stage, 50mg/day sertraline was added to the treatment.
Results
After cranial MRI and EEG recordings were completed, the patient was referred to the neurology department due to the suspicion of autoimmune encephalitis. In the cerebrospinal fluid examination anti-LGI-1 and anti-yo antibodies were positive. Thereupon, IV pulse steroid was given. After that her orientation and disorganized behavior improved. Then, the patient was referred to oncology department.
Conclusions
Limbic encephalitis may manifest as sleep disorders, short-term memory loss, conversion disorder, disorganized behaviors, slurred speech, non-epileptic seizures, sensory and motor defects. Delay in diagnosis may worsen the prognosis of possible malignancy. It should be kept in mind that the patient with a suspected conversion disorder may have limbic encephalitis.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:53:42Z |
| format | Article |
| id | doaj.art-9398fe6a1ce840e8aeb33cee03bb663e |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:53:42Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-9398fe6a1ce840e8aeb33cee03bb663e2023-11-17T05:06:10ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S139S13910.1192/j.eurpsy.2022.377Paraneoplastic Limbic Encephalitis Case Report In A Patient With Suspected Conversion DisorderA.N. Duran Öztürk0O. Sahmelikoglu Onur1N. Karamustafalioglu2Bakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery, Psychiatry, Istanbul, TurkeyBakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery, Psychiatry, Istanbul, TurkeyBakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery, Psychiatry, Istanbul, Turkey Introduction . Autoimmune encephalitis is a difficult-to-recognize, complex disease that can present with various neuropsychiatric symptoms. N-methyl-D-aspartate receptor (NMDA-r) and anti-leucine-rich glioma-inactivated 1 protein (LGI-1) subtypes of autoimmune encephalitis may present with psychiatric symptoms. Objectives We would like to present an autoimmune encephalitis case that can be confused with conversion disorder. Methods A 54-year-old, female patient started to have forgetfulness ten months ago, and convulsions started five months ago. The patient had disorganized behaviors and contractions in the extremities. Diffusion MRI and brain CT images were normal. The patient had low blood sodium level. In the follow-up, her orientation was impaired and she could hardly make eye contact. As the patient’s contractions were evaluated as conversion in the first stage, 50mg/day sertraline was added to the treatment. Results After cranial MRI and EEG recordings were completed, the patient was referred to the neurology department due to the suspicion of autoimmune encephalitis. In the cerebrospinal fluid examination anti-LGI-1 and anti-yo antibodies were positive. Thereupon, IV pulse steroid was given. After that her orientation and disorganized behavior improved. Then, the patient was referred to oncology department. Conclusions Limbic encephalitis may manifest as sleep disorders, short-term memory loss, conversion disorder, disorganized behaviors, slurred speech, non-epileptic seizures, sensory and motor defects. Delay in diagnosis may worsen the prognosis of possible malignancy. It should be kept in mind that the patient with a suspected conversion disorder may have limbic encephalitis. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822003777/type/journal_articleparaneoplasticConversion Disorderautoimmunelimbic encephalitis |
| spellingShingle | A.N. Duran Öztürk O. Sahmelikoglu Onur N. Karamustafalioglu Paraneoplastic Limbic Encephalitis Case Report In A Patient With Suspected Conversion Disorder European Psychiatry paraneoplastic Conversion Disorder autoimmune limbic encephalitis |
| title | Paraneoplastic Limbic Encephalitis Case Report In A Patient With Suspected Conversion Disorder |
| title_full | Paraneoplastic Limbic Encephalitis Case Report In A Patient With Suspected Conversion Disorder |
| title_fullStr | Paraneoplastic Limbic Encephalitis Case Report In A Patient With Suspected Conversion Disorder |
| title_full_unstemmed | Paraneoplastic Limbic Encephalitis Case Report In A Patient With Suspected Conversion Disorder |
| title_short | Paraneoplastic Limbic Encephalitis Case Report In A Patient With Suspected Conversion Disorder |
| title_sort | paraneoplastic limbic encephalitis case report in a patient with suspected conversion disorder |
| topic | paraneoplastic Conversion Disorder autoimmune limbic encephalitis |
| url | https://www.cambridge.org/core/product/identifier/S0924933822003777/type/journal_article |
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