Anti-NMDA receptor encephalitis in older adults: A systematic review of case reports
Por:
Gine-Serven, E, Serra-Mestres, J, Martinez-Ramirez, M, Boix-Quintana, E, Davi-Loscos, E, Guanyabens, N, Casado, V, Muriana, D, Torres-Rivas, C, Cuevas-Esteban, J and Labad, J
Publicada:
1 ene 2022
Ahead of Print:
1 dic 2021
Resumen:
Objective: To ascertain the clinical characteristics of anti-NMDA receptor encephalitis (NMDARE) in older patients. Method: A systematic literature review using PubMed and Scopus of all published case reports of NMDARE was undertaken, from database inception to June 2020. From this, cases reporting on patients older than 65 years of age and whose diagnosis was confirmed by the presence of anti-NMDAR antibodies in CSF were selected. Results: 23 case reports fulfilling the study's criteria were found. Median age was 70.1 years (range 65-84), fourteen were female (60.9%), and mostly presented with acute behavioral and cognitive changes (95.7%). Atypical psychosis occurred in eleven patients (47.8%) with a sudden onset and fluctuating clinical pattern of delusions (39.1%), hallucinations (30.4%), and motility disturbances (34.8%) including catatonia (17.4%). Nine patients presented with seizures (39.1%). Pleocytosis in CSF (>5 WBC) was described in twelve cases (52.2%). Eleven cases (47.8%) had abnormal brain magnetic resonance imaging (MRI) scans with limbic inflammatory lesions. Thirteen patients had an abnormal EEG (56.5%). Conclusion: NMDARE should be included in the differential diagnosis of older patients who present with new psychiatric episodes, especially when characterized by sudden onset psychotic polymorphic symptomatology, fluctuating course with marked cognitive decline, and with catatonic features.
Filiaciones:
Gine-Serven, E:
Hosp Mataro, Dept Psychiat, Consorci Sanitari Maresme, Carretera Cirera S-N, Mataro 08340, Spain
Serra-Mestres, J:
Cardinal Clin, Old Age Psychiat Serv, Windsor SL5 4EL, England
Martinez-Ramirez, M:
Hosp Mataro, Dept Psychiat, Consorci Sanitari Maresme, Carretera Cirera S-N, Mataro 08340, Spain
Boix-Quintana, E:
Hosp Mataro, Dept Psychiat, Consorci Sanitari Maresme, Carretera Cirera S-N, Mataro 08340, Spain
Davi-Loscos, E:
Hosp Mataro, Dept Psychiat, Consorci Sanitari Maresme, Carretera Cirera S-N, Mataro 08340, Spain
Guanyabens, N:
Hosp Mataro, Dept Neurol, Consorci Sanitari Maresme, Mataro, Spain
Casado, V:
Hosp Mataro, Dept Neurol, Consorci Sanitari Maresme, Mataro, Spain
:
Hosp Mataro, Dept Neurol, Consorci Sanitari Maresme, Mataro, Spain
Torres-Rivas, C:
Hosp Mataro, Dept Psychiat, Consorci Sanitari Maresme, Carretera Cirera S-N, Mataro 08340, Spain
:
Hosp Badalona Germans Trias & Pujol, Dept Psychiat, Badalona, Spain
Labad, J:
Hosp Mataro, Dept Psychiat, Consorci Sanitari Maresme, Carretera Cirera S-N, Mataro 08340, Spain
Ctr Invest Red Salud Mental, Madrid, Spain
Univ Autonoma Barcelona, Inst Neurociencies, Inst Innovac & Invest Parc Tauli, Translat Neurosci Res Unit I3PT INc UAB, Barcelona, Spain
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