Considerations of psychotic symptomatology in anti‐NMDA encephalitis: Similarity to cycloid psychosis
Abstract Most patients with anti‐NMDA receptor (NMDAR) encephalitis present with acute psychosis which is difficult to differentiate from psychotic episodes related to a primarily psychiatric disease. A precise description of the psychiatric phenotype of this disease would greatly facilitate the ear...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-12-01
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| Series: | Clinical Case Reports |
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| Online Access: | https://doi.org/10.1002/ccr3.2522 |
| _version_ | 1819208404424458240 |
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| author | Eloi Giné Servén Ester Boix Quintana Nicolau Guanyabens Buscà Virginia Casado Ruiz Cristina Torres Rivas Marta Niubo Gurgui Josep Dalmau Carol Palma |
| author_facet | Eloi Giné Servén Ester Boix Quintana Nicolau Guanyabens Buscà Virginia Casado Ruiz Cristina Torres Rivas Marta Niubo Gurgui Josep Dalmau Carol Palma |
| author_sort | Eloi Giné Servén |
| collection | DOAJ |
| description | Abstract Most patients with anti‐NMDA receptor (NMDAR) encephalitis present with acute psychosis which is difficult to differentiate from psychotic episodes related to a primarily psychiatric disease. A precise description of the psychiatric phenotype of this disease would greatly facilitate the early diagnosis of these patients. We provide here a detailed description of three of these patients and the similarity of the clinical features with cycloid psychosis. All three patients met Perris and Brockington's criteria for cycloid psychosis in the initial phase of the autoimmune process, including among other an acute and polysymptomatic onset, polymorphous psychotic symptomatology, mood swings, and changes in psychomotricity. In addition, none of the patients had experienced an extended psychiatric prodromal phase. External stress factors preceded symptom onset in the three patients, who also showed common base personality traits and intolerance to a range of antipsychotic treatments. Complementary studies disclosed that the three patients had ovarian teratoma as well as abnormal EEG, and CSF antibodies against NMDAR. Patients with anti‐NMDAR encephalitis may present with clinical features that resemble cycloid psychosis. In addition, our patients did not have prodromal history of psychiatric symptoms and showed intolerance to antipsychotic medication, which all should raise concern for anti‐NMDAR encephalitis, prompting CSF antibody testing. |
| first_indexed | 2024-12-23T05:38:51Z |
| format | Article |
| id | doaj.art-b5505c9eaa994c7b9924a58809765969 |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-12-23T05:38:51Z |
| publishDate | 2019-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-b5505c9eaa994c7b9924a588097659692022-12-21T17:58:16ZengWileyClinical Case Reports2050-09042019-12-017122456246110.1002/ccr3.2522Considerations of psychotic symptomatology in anti‐NMDA encephalitis: Similarity to cycloid psychosisEloi Giné Servén0Ester Boix Quintana1Nicolau Guanyabens Buscà2Virginia Casado Ruiz3Cristina Torres Rivas4Marta Niubo Gurgui5Josep Dalmau6Carol Palma7Hospital de Mataró Consorci Sanitari del Maresme Mataró SpainHospital de Mataró Consorci Sanitari del Maresme Mataró SpainHospital de Mataró Consorci Sanitari del Maresme Mataró SpainHospital de Mataró Consorci Sanitari del Maresme Mataró SpainHospital de Mataró Consorci Sanitari del Maresme Mataró SpainHospital de Mataró Consorci Sanitari del Maresme Mataró SpainHospital Clinic‐IDIBAPS Universitat de Barcelona Barcelona SpainHospital de Mataró Consorci Sanitari del Maresme Mataró SpainAbstract Most patients with anti‐NMDA receptor (NMDAR) encephalitis present with acute psychosis which is difficult to differentiate from psychotic episodes related to a primarily psychiatric disease. A precise description of the psychiatric phenotype of this disease would greatly facilitate the early diagnosis of these patients. We provide here a detailed description of three of these patients and the similarity of the clinical features with cycloid psychosis. All three patients met Perris and Brockington's criteria for cycloid psychosis in the initial phase of the autoimmune process, including among other an acute and polysymptomatic onset, polymorphous psychotic symptomatology, mood swings, and changes in psychomotricity. In addition, none of the patients had experienced an extended psychiatric prodromal phase. External stress factors preceded symptom onset in the three patients, who also showed common base personality traits and intolerance to a range of antipsychotic treatments. Complementary studies disclosed that the three patients had ovarian teratoma as well as abnormal EEG, and CSF antibodies against NMDAR. Patients with anti‐NMDAR encephalitis may present with clinical features that resemble cycloid psychosis. In addition, our patients did not have prodromal history of psychiatric symptoms and showed intolerance to antipsychotic medication, which all should raise concern for anti‐NMDAR encephalitis, prompting CSF antibody testing.https://doi.org/10.1002/ccr3.2522anti‐NMDA receptor encephalitisautoimmune encephalitiscycloid psychosisfirst episode of psychosisschizophrenia |
| spellingShingle | Eloi Giné Servén Ester Boix Quintana Nicolau Guanyabens Buscà Virginia Casado Ruiz Cristina Torres Rivas Marta Niubo Gurgui Josep Dalmau Carol Palma Considerations of psychotic symptomatology in anti‐NMDA encephalitis: Similarity to cycloid psychosis Clinical Case Reports anti‐NMDA receptor encephalitis autoimmune encephalitis cycloid psychosis first episode of psychosis schizophrenia |
| title | Considerations of psychotic symptomatology in anti‐NMDA encephalitis: Similarity to cycloid psychosis |
| title_full | Considerations of psychotic symptomatology in anti‐NMDA encephalitis: Similarity to cycloid psychosis |
| title_fullStr | Considerations of psychotic symptomatology in anti‐NMDA encephalitis: Similarity to cycloid psychosis |
| title_full_unstemmed | Considerations of psychotic symptomatology in anti‐NMDA encephalitis: Similarity to cycloid psychosis |
| title_short | Considerations of psychotic symptomatology in anti‐NMDA encephalitis: Similarity to cycloid psychosis |
| title_sort | considerations of psychotic symptomatology in anti nmda encephalitis similarity to cycloid psychosis |
| topic | anti‐NMDA receptor encephalitis autoimmune encephalitis cycloid psychosis first episode of psychosis schizophrenia |
| url | https://doi.org/10.1002/ccr3.2522 |
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