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Catatonia secondary to anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis: a review

Published online by Cambridge University Press:  30 October 2019

Inês Marques Macedo  and
João Gama Marques Open the ORCID record for João Gama Marques [Opens in a new window]
Inês Marques Macedo
Affiliation:
Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal, Europa
João Gama Marques*
Affiliation:
Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal, Europa Consulta de Esquizofrenia Resistente, Hospital Júlio de Matos, Centro Hospitalar Psiquiátrico de Lisboa, Lisboa, Portugal, Europa .
*
*João Gama Marques Email: joaogamamarques@gmail.com
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Abstract

Anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis is a relatively recent autoimmune entity, as it was first described in 2007. Given that it is a condition with neuropsychiatric symptoms, its initial symptom is frequently psychiatric in nature. Hence, psychiatrists are often the first physicians to assess these patients and, as so, must recognize this type of encephalitis as a possible cause. Catatonia may be inaugural or develop throughout the course of the disease. Management of patients with anti-NMDAr encephalitis is based on etiologic treatment with immunotherapy and removal of the associated tumor, if any. However, these catatonic patients may have variable responses to etiologic treatment, sometimes with refractory catatonic symptoms, which attests to the necessary urgency to know how to manage these patients. In the clinical setting, physicians appear to be using guidelines originally created to the management of catatonia due to primary psychiatric conditions. In this literature review, catatonia was historically contextualized and anti-NMDAr encephalitis overall described. Finally, catatonia secondary to this type of encephalitis was discussed.

Keywords

Catatoniaanti-NMDAr encephalitisanti-N-methyl-D-aspartate receptor encephalitisneuropsychiatry
Type
Review
Information
CNS Spectrums , Volume 25 , Issue 4 , August 2020 , pp. 475 - 492
Copyright
© Cambridge University Press 2019

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