Malignant catatonia due to anti-NMDA-receptor encephalitis in a 15-year-old girl: case report and summary of current knowledge

AULICKÁ, Štefánia, Ondřej HORÁK, Lenka MRÁZOVÁ, Peter MIKOLÁŠEK, Jaroslav ŠTĚRBA, Lenka KRBKOVÁ and Hana OŠLEJŠKOVÁ. Malignant catatonia due to anti-NMDA-receptor encephalitis in a 15-year-old girl: case report and summary of current knowledge. Neuropsychiatry. London: Future Medicine Ltd., 2016, vol. 6, No 4, p. 136-141. ISSN 1758-2008.

Basic information

• Original name: Malignant catatonia due to anti-NMDA-receptor encephalitis in a 15-year-old girl: case report and summary of current knowledge
• Authors: AULICKÁ, Štefánia (703 Slovakia, guarantor, belonging to the institution), Ondřej HORÁK (203 Czech Republic, belonging to the institution), Lenka MRÁZOVÁ (203 Czech Republic, belonging to the institution), Peter MIKOLÁŠEK (703 Slovakia, belonging to the institution), Jaroslav ŠTĚRBA (203 Czech Republic), Lenka KRBKOVÁ (203 Czech Republic, belonging to the institution) and Hana OŠLEJŠKOVÁ (203 Czech Republic, belonging to the institution).
• Edition: Neuropsychiatry, London, Future Medicine Ltd. 2016, 1758-2008.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30000 3. Medical and Health Sciences
• Country of publisher: United Kingdom of Great Britain and Northern Ireland
• Confidentiality degree: is not subject to a state or trade secret
• Impact factor: Impact factor: 4.778
• RIV identification code: RIV/00216224:14110/16:00091888
• Organization unit: Faculty of Medicine
• Keywords in English: NMDA receptor antibodies; malignant catatonia; paraneoplastic form; non-paraneoplastic form; immunotherapy
• Tags: EL OK
• Tags: International impact, Reviewed

Abstract

Anti-N-methyl-D-aspartate receptor encephalitis is a recently identified autoimmune disorder with a prominent neuropsychiatric presentation. We present the case of a 15-yearold girl with partial complex seizures with secondary generalization and acute mania with psychotic features. A positive diagnosis of anti-NMDA-receptor encephalitis suggested the specific treatment. Despite first-line immune treatment, the patient progressed to stupor, malignant catatonia, and autonomic instability with the risk of cardiopulmonary function failure. She improved after second-line immunosuppressive therapy (cyclophosphamide and rituximab simultaneously). Post-cognitive sequelae (memory impairment and deliberation) disappeared within 8 months of follow-up treatment and intensive cognitive rehabilitation. This case report emphasizes the importance of differential diagnosis and adequate treatment of catatonic syndrome, especially in young adults. Early recognition and adequate treatment is essential for a good outcome for the patients.

Links

• ROZV/24/LF/2016, interní kód MU: Name: LF - Příspěvek IP 2016

Investor: Ministry of Education, Youth and Sports of the CR