Abstract
BackgroundPsychosis in pregnancy is rare and could be life-threatening. It requires prompt evaluation and proper management accordingly. Anti-N-methyl-d-aspartate receptor (anti-NMDAr) encephalitis following herpes simplex virus (HSV) infection is a rare cause of psychosis during pregnancy.Case presentationA 20-year-old woman at 18 weeks gestation presented with agitation and a 3-day history of hallucinations. She had a prior hospitalization for HSV encephalitis 6 weeks before. Her laboratory workup was unremarkable except for positive anti-NMDAr antibodies in the CSF. The patient was treated with high-dose corticosteroids and plasmapheresis, and she was discharged 2 weeks later fully recovered.ConclusionsAnti-NMDAr encephalitis can be the culprit behind a new-onset of psychosis in pregnancy. Early diagnosis and treatment are crucial.
Highlights
Psychosis in pregnancy is rare and could be life-threatening
Anti-NMDAr encephalitis is rare in pregnancy, and its psychiatric features resemble many primary mental disorders that could present with acute psychosis
We report the case of a young pregnant woman presenting with an acute psychotic episode 3 weeks after recovering from herpes simplex virus (HSV) encephalitis
Summary
Psychosis in pregnancy is rare and could be life-threatening. It requires prompt evaluation and proper management . It is postulated that autoantibodies target the Nu1 subunit of the NMDA receptor, decreasing its activity, and leading to symptoms of anti-NMDAr encephalitis. The two known triggers of anti-NMDAr encephalitis are tumors and infectious agents, the herpes simplex virus (HSV). Anti-NMDAr encephalitis is rare in pregnancy, and its psychiatric features resemble many primary mental disorders that could present with acute psychosis.
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