Effect of Clozapine on Anti-N-Methyl-D-Aspartate Receptor Encephalitis With Psychiatric Symptoms: A Series of Three Cases
| Autor: | Yong Zhu, Liang Li, Tianhao Huang, Ping Yang, Bin Zhou, Huiyong Huang, Gaoya Zhou, Feng Li, Shuaishuai Xia, Erwen Tu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment hormone Case Report Disease Irritability lcsh:RC321-571 03 medical and health sciences 0302 clinical medicine Delusion intravenous immunoglobulin antipsychotic therapy medicine Antipsychotic Psychiatry lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry Clozapine Anti-NMDA receptor encephalitis clozapine business.industry General Neuroscience anti-NMDA receptor encephalitis medicine.disease 030227 psychiatry psychiatric symptoms Hormone therapy medicine.symptom business 030217 neurology & neurosurgery Encephalitis Neuroscience medicine.drug |
| Zdroj: | Frontiers in Neuroscience Frontiers in Neuroscience, Vol 13 (2019) |
| ISSN: | 1662-453X |
| DOI: | 10.3389/fnins.2019.00315 |
| Popis: | The main clinical manifestations of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis are acute or subacute seizures, cognition impairment, and psychiatric symptoms. Nowadays, the scheme of antipsychotic therapy for this disease has not been established. This study reports three cases of anti-NMDAR encephalitis with psychiatric symptoms. The anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum were positive. The psychiatric symptoms still existed after intravenous immunoglobulin (IVIG) treatment; thus, clozapine was used for antipsychotic therapy. Case 1 was a 37-year-old man who suffered from bad mood and suicide behaviors for 1 month. Hallucination and delusion still existed after IVIG treatment and hormone therapy, and the symptoms were relieved when given clozapine for 12 months. Case 2 was a 28-year-old man who was admitted to our hospital due to injuring other people and destructive behaviors for 2 days. He showed irritability, bad temper, declined cognition, and severe delusion of persecution after IVIG treatment and hormone therapy, but the psychiatric symptoms disappeared when given clozapine for 3 months. Case 3 was a 23-year-old man who suffered from headache and babbing for 7 days. Symptoms such as irritability, bad temper, babbing, and injuring other people still existed after IVIG treatment and hormone therapy, but they disappeared when given clozapine for 2 months. Therefore, we suggest that during the treatment of anti-NMDAR encephalitis with psychiatric symptoms, if the anti-NMDAR antibodies in CSF and serum were positive, and psychiatric symptoms could not be controlled after IVIG and hormone therapy, clozapine may work. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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