Engelsk titel: Anti-NMDA-receptor encephalitis
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Författare:
Engen, Kristine
;
Agartz, Ingrid
Email: kristine.engen@medisin.uio.no
Språk: Nor
Antal referenser: 32
Dokumenttyp:
Översikt
UI-nummer: 16077659
Sammanfattning
BACKGROUND In 2007 a clinical disease caused by autoantibodies directed against the N-methyl-D-aspartate (NMDA)
receptor was described for the first time. Anti-NMDA-receptor encephalitis is a subacute, autoimmune neurological disorder with
psychiatric manifestations. The disease is a form of limbic encephalitis and is often paraneoplastic. The condition is also
treatable. In this review article we examine the development of the disease, clinical practice, diagnostics and treatment.
MATERIAL AND METHOD The article is based on references retrieved from searches in PubMed, and a discretionary selection of
articles from the authors’ own literature archive.
RESULTS The disease most frequently affects young women. It may initially be perceived as a psychiatric condition, as it usually
presents in the form of delusions, hallucinations or mania. The diagnosis should be suspected in patients who later develop
neurological symptoms such as various movement disorders, epileptic seizures and autonomic instability. Examination of serum
or cerebrospinal fluid for NMDA receptor antibodies should be included in the assessment of patients with suspected
encephalitis. MRI, EEG and assessment for tumours are important tools in diagnosing the condition and any underlying
malignancy.
INTERPRETATION If treatment is initiated early, the prognosis is good. Altogether 75 % of patients will fully recover or experience
significant improvement. Apart from surgical resection of a possible tumour, the treatment consists of immunotherapy. Because of
good possibilities for treatment, it is important that clinicians, particularly those in acute psychiatry, are aware of and alert to this
condition.