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10.1212/NXI.0000000000000280

http://scihub22266oqcxt.onion/10.1212/NXI.0000000000000280
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C5004531!5004531!27606355
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suck abstract from ncbi


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pmid27606355      Neurol+Neuroimmunol+Neuroinflamm 2016 ; 3 (5): ä
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  • Neuroleptic intolerance in patients with anti-NMDAR encephalitis #MMPMID27606355
  • Lejuste F; Thomas L; Picard G; Desestret V; Ducray F; Rogemond V; Psimaras D; Antoine JC; Delattre JY; Groc L; Leboyer M; Honnorat J
  • Neurol Neuroimmunol Neuroinflamm 2016[Oct]; 3 (5): ä PMID27606355show ga
  • Objective:: To precisely describe the initial psychiatric presentation of patients with anti-NMDA receptor (NMDAR) antibodies encephalitis (anti-NMDAR encephalitis) to identify potential clues enhancing its early diagnosis. Methods:: We retrospectively studied the French Reference Centre medical records of every adult patient with anti-NMDAR encephalitis to specify the patients' initial psychiatric symptoms leading to hospitalization in a psychiatric department and the reasons underlying the diagnosis of anti-NMDAR encephalitis. Results:: The medical records of 111 adult patients were reviewed. Psychiatric features were the initial presentation in 65 patients (59%). Among them, several psychiatric manifestations were observed, including visual and auditory hallucinations (n = 26, 40%), depression (n = 15, 23%), mania (n = 5, 8%), acute schizoaffective episode (n = 15, 23%), and eating disorder or addiction (n = 4; 6%). Forty-five patients (40% of total cohort) were first hospitalized in a psychiatric institution (91% women), with a median duration of stay of 9 days (range 0.25?239 days). Among them, 24 patients (53%) had associated discreet neurologic signs at the first evaluation, while 17 additional patients (38%) developed neurologic signs within a few days. Twenty-one patients (47%) were transferred to a medical unit for a suspicion of antipsychotic intolerance characterized by high temperature, muscle rigidity, mutism or coma, and biological results suggesting rhabdomyolysis. Conclusions:: Several psychiatric presentations were observed in patients with anti-NMDAR encephalitis, although none was specific; however, patients, mostly women, also had discreet neurologic signs that should be carefully assessed as well as signs of antipsychotic intolerance that should raise suspicion for anti-NMDAR encephalitis.
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