Abstract
Objective: We conducted this study to analyze the clinical characteristics of the psychiatric symptoms of patients with anti-NMDAR encephalitis.Methods: A retrospective study of anti-NMDAR encephalitis in China was performed. The clinical characteristics of the psychiatric symptoms, the relationship between the antibodies titers and clinical characteristics of patients with anti-NMDAR encephalitis were determined.Results: A total of 108 patients with a definitive diagnosis of anti-NMDAR encephalitis were included in this study. 103 patients (95%) developed one or several psychiatric symptoms. The comparison of the high titer group and the low titer group showed that more patients presented psychiatric symptoms as the initial symptom in the high titer group (P = 0.020), the prevalence of the symptoms such as depressive, catatonic, and central hypoventilation were also higher in the high titer group than the low titer group (P = 0.033, 0.031 and 0.006, respectively). Meanwhile, more patients received a combination treatment of IVIg and corticosteroids in the high titer group than the low titer group and patients in high titer group were prescript with anti-psychiatric drugs more often than the patients in low titer group (P = 0.026 and 0.003, respectively).Conclusions: Psychiatric symptoms are the most common clinical characteristics of patients with anti-NMDAR encephalitis. Patients with higher antibodies titers more often presented with psychiatric symptoms as the initial symptom, and showed a more severe clinical feature. Screening for the anti-NMDAR antibodies is essentially important in patients who present psychiatric symptoms with or without other neurological symptoms.
Highlights
MethodsA retrospective study of anti-NMDAR encephalitis in China was performed
Specialty section: This article was submitted to Epilepsy, a section of the journal Frontiers in Neurology
Screening for the anti-NMDAR antibodies is essentially important in patients who present psychiatric symptoms with or without other neurological symptoms
Summary
A retrospective study of anti-NMDAR encephalitis in China was performed. The clinical characteristics of the psychiatric symptoms, the relationship between the antibodies titers and clinical characteristics of patients with anti-NMDAR encephalitis were determined. Patients who presented with psychiatric symptoms, seizures or focal neurological signs were tested for the presence of NMDAR antibodies in serum or CSF sample at the West China Hospital of Sichuan University between June 2011 and April 2016. All patient who tested positive for anti-NMDAR antibodies in CSF or/and serum were included in this study and patients lacking key clinical data or suspecting of virus encephalitis or other infectious encephalitis were excluded. The diagnosis of antiNMDAR encephalitis is consistent with previous studies [5, 6]. The diagnosis of each category meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) [7, 8]
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