Quick Post – Anti-NMDA receptor encephalitis – Autism

Apologies poor formatting Pub Med Dutch original.

[Anti-NMDA-receptor encephalitis: a new axis-III disorder in the differential diagnosisof childhood disintegrative disorder, early onset schizophrenia and late onset autism].

[Article in Dutch]

http://www.ncbi.nlm.nih.gov/pubmed/22588963

Summary Childhood disintegrative disorder cdd, early onset schizophrenia , and late onset autism ( loa)  often follow a similar course: initially, development is normal, then there is a sudden neuropsychiatric deterioration of social interaction and communication skills, which is combined with a decline in intelligence and reduction in daily activities.

A 9-year-old boy was admitted to the paediatric ward with acute onset of secondary epileptic seizures. It was not long until the boys symptoms resembled that of patients with cdd, eos and loa Intensive tests led to the diagnosis of anti-nmda-receptor encephalitis. Anti-nmda-receptor encephalitis should be regarded as a possible organic cause underlying the syndromal presentation of cdd, eos and loa.

Further reading – http://en.wikipedia.org/wiki/Anti-NMDA_receptor_encephalitis

Anti-NMDA (N-methyl D-aspartate) receptor encephalitis is an acute form of encephalitis, potentially lethal but with high probability for recovery, caused by autoimmune reaction against NR1- and NR2-subunits of the glutamate NMDA receptor.[1] Different descriptions and syndromal designations for this disease existed in the medical literature prior to 2007, when the cause was established and it received its current name.[2] The disease is associated with tumours, mostly teratomas of the ovaries, and thus is considered a paraneoplastic syndrome. Howerever, there are a substantial number of cases with no detectable cancerous tissue.

According to a review of 100 cases in The Lancet,[3] 91 of the 100 patients were women, mean age of all patients numbered 23 years (5-76 range); of the 98 patients that underwent an oncological screening 58 had a tumour, predominantly an ovarian teratoma. All patients presented with psychiatric symptoms or memory problems; 76 of them suffered from seizures, 88 developed unresponsiveness (decreased consciousness), 86 – dyskinesias, 69 – autonomic instability, and 66 – hypoventilation. Tumour treatment associated with better prognosis; 75 patients got well without residual problems and 25 died or were left with severe deficits.

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