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Syndrome catatonique précoce et encéphalite à auto-anticorps antirécepteurs-NMDA : une mise au point.
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- Author(s): Parenti, A.1 ; Delion, P.1; Geoffroy, P.A.1; Meurisse, C.2; Cuisset, J.M.2; Joriot, S.2; Nasser, H.3; Trauffler, A.2; Kechid, G.1; Goeb, J.L.4; Hagneré, L.1; Jardri, R.1; Vallée, L.2
- Source:
Neuropsychiatrie de l'enfance & de l'Adolescence. May2015, Vol. 63 Issue 3, p201-206. 6p. - Source:
- Additional Information
- Abstract: Résumé L’encéphalite auto-immune à anticorps antirécepteurs au N-Méthyl-D-Aspartate (NMDA) est une atteinte grave du système nerveux central, encore peu connue des cliniciens, pouvant être à l’origine de symptômes psychiatriques frustres comportant des symptômes psychotiques ou catatoniques. Nous rapportons ici le cas d’une jeune fille de 15 ans, sans antécédent personnel notable, hospitalisée pour décompensation psychotique de début brutal, rapidement compliquée d’une catatonie agitée puis stuporeuse, répondant insuffisamment au traitement par benzodiazépines. Le diagnostic d’encéphalite à anticorps anti-R NMDA a pu être confirmé par le dosage des auto-anticorps dans le liquide céphalorachidien (LCR). L’évolution sera favorable sous corticoïdes et immunosuppresseurs. Nous proposons à l’issue de ce cas, une mise au point sur l’encéphalite à auto-anticorps anti-R NMDA et sur l’hypothèse d’un déséquilibre de la balance excitation/inhibition à l’origine de la catatonie. Anti-NMDAR encephalitis is a serious central nervous system disorder, not well known, that may lead to non specific psychiatric symptoms, ranging from psychosis to catatonia. We report the case of a 15-year-old girl, without significant medical history, hospitalized in a context of first-episode psychosis, quickly followed by agitated and stuporous catatonia, with only poor response to benzodiazepine treatment. Titration of autoantibodies in the cerebrospinal fluid confirmed the diagnosis of anti-NMDAR encephalitis. Recovery was obtained thanks to corticotherapy and immunosuppressive agents. In complement to this clinical report, we propose a literature update on anti-NMDA-R encephalitis and the excitatory/inhibitory imbalance as the potential mechanism at the root of catatonia. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Neuropsychiatrie de l'enfance & de l'Adolescence is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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