Share This Article:

Neuropsychological Profile of Anti-NMDA Receptor Encephalitis

Abstract Full-Text HTML Download Download as PDF (Size:370KB) PP. 776-781
DOI: 10.4236/psych.2013.410110    5,101 Downloads   7,533 Views   Citations

ABSTRACT

Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is a life-threatening disorder that often occurs as a paraneoplastic encephalitis and usually begins with neuropsychological or psychiatric symptoms. We report a case of NMDA receptor encephalitis due to an ovarian teratoma, which began with severe and progressive amnesia and behavioral changes, reversed after surgical treatment and plasmapheresis. Using a battery of cognitive tests, its neuropsychological profile before treatment showed a complete alteration of the short and long term memory of both verbal and visual fixation, with clear improvement with cues and with intrusions, and saving other cognitive domains, such as working, episodic and semantic memory, executive, visuospatial, praxical thinking and language functions. These deficits reverted to normalcy with treatment. So, we can conclude that anti-NMDA receptor encephalitis is a rare entity that can be potentially serious depending on early management and diagnosis. We must suspect this entity in children or young people presenting with behavioural disturbances and crisis, with a cognitive pattern of complete alteration in short and long term memory improving with cues, and respecting other cognitive domains.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Marcos-Arribas, L. , Almonacid, J. & Dolado, A. (2013). Neuropsychological Profile of Anti-NMDA Receptor Encephalitis. Psychology, 4, 776-781. doi: 10.4236/psych.2013.410110.

References

[1] Alexopoulos, H., Kosmidis, M. L., Dalmau, J., & Dalakas, M. C. (2011) Paraneoplastic anti-NMDAR encephalitis: Long term follow-up reveals persistent serum antibodies. Journal of Neurology, 258, 1568-1570. http://dx.doi.org/10.1007/s00415-011-5982-4
[2] Armangue, T., Petit-Pedrol, M., Dalmau, J. (2012). Autoimmune encephalitis in children. Journal Child Neurology, volume 11, pages 1460-9. http://dx.doi.org/10.1177/0883073812448838
[3] Boeck, A.L., Logemann, F., Krauß, T., Hussein, K., Bültmann, E., Trebst, C., & Stangel, M. (2013). Ovarectomy despite negative imaging in anti-NMDA receptor encephalitis: Effective even late. Case Reports in Neurological Medicine, 2013, Article ID: 843192.
[4] Buschke, H., Kuslansky, G., Katz, M., Stewart, W. F., Sliwinski, M. J., Eckholdt, H. M., & Lipton, R. B. (1999). Screening for dementia withthe memory impairment screen. Neurology, 2, 231-238.
http://dx.doi.org/10.1212/WNL.52.2.231
[5] Carnero, C., & Montoro, M. T. (2004). El Test de las Fotos. Revista de Neurología, 9, 801-806.
[6] Dalmau, J., Gleichman, A. J., Hughes, E. G., et al. (2008) Anti-NMDA-receptor encephalitis: Case series and analysis of the effects of antibodies. The Lancet Neurology, 7, 1091-1098.
http://dx.doi.org/10.1016/S1474-4422(08)70224-2
[7] Dabner, M., McCluggage, W. G., Bundell, C., Carr, A., Leung, Y., Sharma, R., & Stewart, C. J. (2012). Ovarian teratoma associated with anti-N-methyl D-aspartate receptor encephalitis: A report of 5 cases documenting prominent intratumoral lymphoid infiltrates. International Journal of Gynecological Pathology, 31, 429-437.
http://dx.doi.org/10.1097/PGP.0b013e31824a1de2
[8] Dabner, M., McCluggage, W. G., Bundell, C., Carr, A., Leung, Y., Sharma, R., & Stewart, C. J. (2012). Ovarian teratoma associated with anti-N-methyl D-aspartate receptor encephalitis: A report of 5 cases documenting prominent intratumoral lymphoid infiltrates. International Journal of Gynecological Pathology, 31, 429-437.
http://dx.doi.org/10.1097/PGP.0b013e31824a1de2
[9] Finke, C., Kopp, U. A., Prüss, H., Dalmau, J., Wandinger, K. P., & Ploner, C. J. (2012). Cognitive deficits following anti-NMDA receptor encephalitis. Journal of Neurology, Neurosurgery & Psychiatry, 83, 195-198. http://dx.doi.org/10.1136/jnnp-2011-300411
[10] Iizuka, T., Yoshii, S., Kan, S., et al. (2010). Reversible brain atrophy in anti-NMDA receptor encephalitis: A long-term observational study. Journal of Neurology, 257, 1686-1691.
http://dx.doi.org/10.1007/s00415-010-5604-6
[11] Johnson, N., Henry, C., Fessler, A. J., & Dalmau, J. (2010). Anti-NMDA receptor encephalitis causing prolonged nonconvulsive status epilepticus. Neurology, 75, 1480-1482.
http://dx.doi.org/10.1212/WNL.0b013e3181f8831a
[12] Lebon, S., Mayor-Dubois, C., Popea, I., Poloni, C., Selvadoray, N., Gumy, A., & Roulet-Perez, E. (2012). Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis mimicking a primary psychiatric disorder in an adolescent. Journal of Child Neurology, 27, 1607-1610.
http://dx.doi.org/10.1177/0883073812438099
[13] Peery, H. E., Day, G. S., Doja, A., Xia, C., Fritzler, M. J., & Foster, W. G. (2013). Anti-NMDA receptor encephalitis in children: The disorder, its diagnosis, and treatment. Handbook of Clinical Neurology, 112, 1229-1233.
http://dx.doi.org/10.1016/B978-0-444-52910-7.00045-3
[14] Pham, H. P., Daniel-Johnson, J. A., Stotler, B. A., Stephens, H., & Schwartz, J. (2011). Therapeutic plasma exchange for the treatment of anti-NMDA receptor encephalitis. Journal of Clinical Apheresis, 26, 320-325. http://dx.doi.org/10.1002/jca.20311
[15] Prüss, H., Dalmau, J., Harms, L., Holtje, M., Ahnert-Hilger, G., Borowski, K., Stoecker, W., & Wandinger, K. P. (2010). Retrospective analysis of NMDA receptor antibodies in encephalitis of unknown origin. Neurology, 75, 1735-1739.
http://dx.doi.org/10.1212/WNL.0b013e3181fc2a06
[16] Rosenfeld, M. R., Dalmau, J. (2011). Anti-NMDA-receptor encephalitis and other synaptic autoimmune disorders. Current Treatment Options in Neurology, 13, 324-332.
http://dx.doi.org/10.1007/s11940-011-0116-y
[17] Rosenfeld, M. R., & Dalmau, J. O. (2012). Paraneoplastic disorders of the CNS and autoimmune synaptic encephalitis. Continuum (Minneaplis, Minn), 2, 366-383.
http://dx.doi.org/10.1212/01.CON.0000413664.42798.aa
[18] Rosenfeld, M. R., Titulaer, M. J., & Dalmau, J. (2012). Paraneoplastic syndromes and autoimmune encephalitis: Five new things. Neurology Clinical Practice, 2, 215-223.
http://dx.doi.org/10.1212/CPJ.0b013e31826af23e
[19] Suzuki, S., Seki, M., & Suzuki, N. (2013). Recent concept of limbic encephalitis: Progress in anti-NMDA receptor encephalitis. Japanese Journal of Clinical Immunology, 36, 86-94.
http://dx.doi.org/10.2177/jsci.36.86
[20] Tanyi, J. L., Marsh, E. B., Dalmau, J., & Chu, C. S. (2012). Reversible paraneoplastic encephalitis in three patients with ovarian neoplasms. Acta Obstetricia et Gynecologica Scandinavica, 91, 630-634.
[21] Titulaer, M. J., McCracken, L., Gabilondo, I., et al. (2013). Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: An observational cohort study. The Lancet Neurology, 12, 157-165.
http://dx.doi.org/10.1016/S1474-4422(12)70310-1
[22] Young, P. J., Baker, S., Cavazzoni, E., Erickson, S. J., Krishnan, A., Kruger, P. S., Rashid, A. H., & Wibrow, B. A. (2013). A case series of critically ill patients with anti N-methyl-D-aspartate receptor encephalitis. Critical Care and Resuscitation, 1, 8-14.
[23] Waas, J. A., & Storm, A. H. (2012). Anti-NMDA-receptor encephalitis: A neuropsychiatric illness requiring further study. Tijdschrift voor Psychiatrie, 54, 279-283.
[24] Zuliani, F., Graus, F., Giometto, B., et al. (2012). Central nervous system neuronal surface antibody associated syndromes: Review and guidelines for recognition. Journal of Neurology, Neurosurgery & Psychiatry, 83, 638-645.
http://dx.doi.org/10.1136/jnnp-2011-301237

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.