Malignant catatonia due to anti-NMDA-receptor encephalitis in a 15-year-old girl: case report and summary of current knowledge

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Publikace nespadá pod Filozofickou fakultu, ale pod Lékařskou fakultu. Oficiální stránka publikace je na webu muni.cz.
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AULICKÁ Štefánia HORÁK Ondřej MRÁZOVÁ Lenka MIKOLÁŠEK Peter ŠTĚRBA Jaroslav KRBKOVÁ Lenka OŠLEJŠKOVÁ Hana

Rok publikování 2016
Druh Článek v odborném periodiku
Časopis / Zdroj Neuropsychiatry
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Obor Neurologie, neurochirurgie, neurovědy
Klíčová slova NMDA receptor antibodies; malignant catatonia; paraneoplastic form; non-paraneoplastic form; immunotherapy
Popis Anti-N-methyl-D-aspartate receptor encephalitis is a recently identified autoimmune disorder with a prominent neuropsychiatric presentation. We present the case of a 15-yearold girl with partial complex seizures with secondary generalization and acute mania with psychotic features. A positive diagnosis of anti-NMDA-receptor encephalitis suggested the specific treatment. Despite first-line immune treatment, the patient progressed to stupor, malignant catatonia, and autonomic instability with the risk of cardiopulmonary function failure. She improved after second-line immunosuppressive therapy (cyclophosphamide and rituximab simultaneously). Post-cognitive sequelae (memory impairment and deliberation) disappeared within 8 months of follow-up treatment and intensive cognitive rehabilitation. This case report emphasizes the importance of differential diagnosis and adequate treatment of catatonic syndrome, especially in young adults. Early recognition and adequate treatment is essential for a good outcome for the patients.
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