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| Published: June 30, 2022
Psychiatric Manifestation of NMDA Receptor Autoimmune Encephalitis
Postgraduate trainee-2, Department of Psychiatry, RIMS, Imphal, Manipur Google Scholar More about the auther
Postgraduate trainee-3, Department of Psychiatry, RIMS, Imphal, Manipur Google Scholar More about the auther
Professor, Department of Psychiatry, RIMS, Imphal, Manipur Google Scholar More about the auther
DIP: 18.01.126.20221002
DOI: 10.25215/1002.126
ABSTRACT
Miss A, a 13-year-old female was admitted with complaints of sub-acute and continuous course of low mood and being lost in her own thoughts (on and off); odd behaviour in the form of seeing things not seen by others and two episodes of abnormal body movements, forgetfulness, decreased sleep and decreased food intake and restlessness for a period of 1 week. Initially her psychiatric symptoms led to a provisional diagnosis of a primary psychiatric disorder as stressor in the form of decreased academic decline was present. However, over the next few days, it was noticed that the patient’s condition deteriorated as she kept lying on the bed staring blankly onto the roof. Even though the eyes were opened, she not aware of her surroundings and was very restless. She started producing low tone sounds as if humming which alternated with shouting incoherent sounds. Hand movements in the form of twisting and writhing which seemed that she was dancing as well as bizarre facial movements started manifesting. The patient also started having difficulty in breathing with sudden drop in SpO2 upto 86%. Two episodes of seizure also developed. Neurological consultation was sought and she was immediately shifted to Neuro ICU, where necessary investigations were performed. Even though brain MRI came out normal and CSF Analysis did not show other abnormalities, except for increased sugar level. AE panel report showed “strong positive” against NMDA receptor autoantibodies. She was treated with Inj. Methylprednisolone 750 mg in 500ml NS over 4 hours (for 5 days) which was followed by Inj. Prednisolone 50mg for 10 days, then 40mg for 10 days, and then 30 mg for another three months). Patient improved after about 15 days.
This is an Open Access Research distributed under the terms of the Creative Commons Attribution License (www.creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any Medium, provided the original work is properly cited.
© 2022, Muivah, A, Cherak R M, S & Bihari Singh, Th
Received: March 05, 2022; Revision Received: June 28, 2022; Accepted: June 30, 2022
Article Overview
ISSN 2348-5396
ISSN 2349-3429
18.01.126.20221002
10.25215/1002.126
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Published in Volume 10, Issue 2, April-June, 2022