Nyupptäckt autoimmun encefalit misstogs för psykisk sjukdom. Anti-NMDA-receptorencefalit ställer krav på korrekt differentialdiagnostik
Engelsk titel: Newly discovered autoimmune encephalitis wrongly mistaken for mental disease. Anti-NMDA receptor encephalitis puts demands on correct differential diagnosis
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Författare:
Piehl, Fredrik
;
Winnerbäck, Kajsa
Email: fredrik.piehl@ki.se
Språk: Swe
Antal referenser: 7
Dokumenttyp:
Fallbeskrivning
UI-nummer: 10031574
Sammanfattning
A 51-year-old woman was admitted to psychiatric care due to rapidly progressing psychiatric symptoms that developed over a few days. She subsequently developed seizures, delirium, catatonia, dyskinesias and autonomic instability and was transferred to a neurology clinic. Pleocytosis was found in the cerebrospinal fluid, EEG showed a diffuse slowing of activity and repeated magnetic resonance imaging of the brain was normal. Testing for N-methyl-D-aspartate (NMDA) autoantibodies in cerebrospinal fluid was positive. She was treated with high dose methylprednisolone and intravenous immunoglobulins. Computerized tomography of thorax, abdomen and pelvis was without signs of any tumour. However, she was found to have a chronic active hepatitis C infection, which may suggest a parainfectious phenonomen. Over the course of the following two months she recovered almost completely, with only mild deficits in memory and concentration remaining.