Navigation Links
Isolated psychiatric episodes rare, but possible, in common form of autoimmune encephalitis
Date:7/26/2013

PHILADELPHIA - A small percentage of people diagnosed with a mysterious neurological condition may only experience psychiatric changes - such as delusional thinking, hallucinations, and aggressive behavior - according to a new study by researchers in the Perelman School of Medicine at the University of Pennsylvania. In addition, people who had previously been diagnosed with this disease, called anti-NMDA receptor (anti-NMDAR) encephalitis, had relapses that only involved psychiatric behavior. In an article published Online First in JAMA Neurology, researchers suggest that, while isolated psychiatric episodes are rare in anti-NMDAR encephalitis cases, abnormal test findings or subtle neurological symptoms should prompt screening for the condition, as it is treatable with immunotherapies.

Within a large group of 571 patients with confirmed Anti-NMDAR Encephalitis, only 23 patients (4 percent) had isolated psychiatric episodes. Of the 23, 5 patients experienced the onset of behavior changes as their only symptoms, without neurological changes, while 18 patients had psychiatric symptoms emerge at the outset of a relapse of Anti-NMDAR Encephalitis in which no neurological changes were identified. After being treated for the condition, 83 percent of these patients recovered substantially or completely.

"While many patients with Anti-NMDAR Encephalitis present with isolated psychiatric symptoms, most of these patients subsequently develop, in a matter of days, additional neurological symptoms which help to make the diagnosis of the disease. In the current study, we find out that a small percentage of patients do not develop neurological symptoms, or sometimes these are very subtle and transitory. Studies using brain MRI and analysis of the cerebrospinal fluid may help to demonstrate signs of inflammation," said Josep Dalmau, MD, PhD, adjunct professor of Neurology. "For patients who have been previously diagnosed with Anti-NMDAR Encephalitis and are in remission, any behavior change may present a relapse and should be tested quickly and treated aggressively."

Anti-NMDAR Encephalitis is one of the most common forms of autoimmune encephalitis, and symptoms can include psychiatric symptoms, memory issues, speech disorders, seizures, involuntary movements, and loss of consciousness. In an earlier Penn Medicine study, 38 percent of all patients (and 46 percent of females with the condition) were found to have a tumor, most commonly it was an ovarian tumor. When correctly diagnosed and treated early, Anti-NMDAR Encephalitis can be effectively treated.

"For patients with new psychotic symptoms that are evaluated in centers where an MRI, EEG or spinal fluid test may not have been administered, there is a chance that Anti-NMDAR Encephalitis may be missed," said lead author Matthew Kayser, MD, PhD, postdoctoral fellow and attending physician in Psychiatry at Penn. "However, the likelihood of pure or isolated new-onset psychosis to be anti-NMDAR encephalitis gradually decreases if no other symptoms emerge during the first 4 weeks of psychosis."

Anti-NMDAR Encephalitis was first characterized by Penn's Josep Dalmau, MD, PhD, adjunct professor of Neurology, and David R. Lynch, MD, PhD, associate professor of Neurology and Pediatrics, in 2007. One year later, the same investigators, in collaboration with Rita Balice-Gordon, PhD, professor of Neuroscience, characterized the main syndrome and provided preliminary evidence that the antibodies have a pathogenic effect on the NR1 subunit of the NMDA receptor in the Lancet Neurology in December 2008. The disease can be diagnosed using a test developed at the University of Pennsylvania and currently available worldwide. With appropriate treatment, approximately 81 percent of patients significantly improve and, with a recovery process that takes an average of 2 years, can fully recover.


'/>"/>

Contact: Kim Menard
kim.menard@uphs.upenn.edu
215-662-6183
University of Pennsylvania School of Medicine
Source:Eurekalert

Related medicine news :

1. Dermaroller Introduces eDermaStamp® – New Technology for Stretch Marks and Isolated Acne Scars
2. Symptomatic behaviour in childhood strongly predicts psychiatric treatment as a young adult
3. Psychiatric Patients Often Wait Nearly 12 Hours in ER
4. Bias found in mental health drug research presented at major psychiatric meeting
5. Childless women with fertility problems at higher risk of hospitalization for psychiatric disorders
6. Children with autism arrive at emergency room for psychiatric crisis 9 times more than peers
7. For Psychiatric Patients, Cancer Is Often Spotted Too Late
8. Protecting psychiatric medical records puts patients at risk of hospitalization
9. Study examines link between incarceration and psychiatric disorders
10. Frontiers publishes systematic review on the effects of yoga on major psychiatric disorders
11. Family practice offers genetic tests to predict effective psychiatric meds, a CAMH study
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/12/2017)... ... , ... Planet Fitness, one of the largest and fastest growing franchisors and ... flagship location in Covington, LA at 401 N. U.S. Highway 190, in January of ... Depot in the Holiday Square shopping center. Its location allows it to serve both ...
(Date:10/12/2017)... ... , ... The American College of Medical Informatics (ACMI) will present the 2017 ... Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s Annual Symposium is ... pioneer in the field of medical informatics, this prestigious award is presented to an ...
(Date:10/12/2017)... ... October 12, 2017 , ... Dr. Parsa Mohebi, ... a medical article to the newly revamped Cosmetic Town journal section, ... hair transplant procedure known as Follicular Unit Extraction (FUE). , Dr. ...
(Date:10/12/2017)... ... October 12, 2017 , ... On Saturday, October 21, the Health & ... by Moonlight to raise money for the American Heart Association Heart Walk. Teams of ... will work together to keep their treadmills moving for 5 hours. Treadmills will start ...
(Date:10/12/2017)... ... October 12, 2017 , ... In the ... a year. In some states—like New York, New Jersey, Massachusetts, Texas, Virginia, Connecticut, ... retirement havens have extremely low property-tax rates, which contributes to the relatively lower ...
Breaking Medicine News(10 mins):
(Date:9/18/2017)... Mich. , Sept. 18, 2017  PMD Healthcare ... Specialty Pharmacy of Kalamazoo, Mich. , ... hub service that expedites and streamlines patient and provider ... PD 2.0, and wellness management services.  ... device used to measure lung function for a variety ...
(Date:9/12/2017)... NEW YORK , Sept. 12, 2017   EcoVadis , the ... chains, has published the first annual edition of its Global CSR Risk ... 20,400 companies evaluated by EcoVadis, based on Scorecard Ratings that analyzed nearly ... ... Performance Index ...
(Date:9/9/2017)... 2017 ... coming to Washington DC ... Tuesday, September 12 th – Monday, September 18 th .The Brain ... MRI brain scans to the public.Where:  BTF,s Mobile ... 501 K Street NW, Washington, D.C.What:BTF brings its nationwide initiative, the Road ...
Breaking Medicine Technology: