Anti-NMDA receptor encephalitis with paroxysmal sympathetic hyperactivity: an under-recognized association?
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While autonomic instability occurs as part of anti-N-methyl D-aspartate (anti-NMDA) receptor encephalitis, anti-NMDA receptor encephalitis is not a recognized cause of the clinical syndrome of paroxysmal sympathetic hyperactivity (PSH). We present a case of anti-NMDA receptor encephalitis in which PSH was a cardinal feature and discuss the mechanistic implications of such an association.
A 31-year-old woman had a generalized tonic–clonic seizure and then developed progressively worsening neuropsychiatric symptoms, including mania, hallucinations, echolalia, and suicidal ideation. She was previously healthy; she did not have any known medical or psychiatric disease. She was not on any medications prior to presentation. She was initially admitted to a psychiatric unit but was transferred to a medical ward after one week of psychiatric treatment, as her symptoms worsened despite anti-psychotic medications. Neurologic examination was notable for catatonia that progres ...
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- Anti-NMDA receptor encephalitis with paroxysmal sympathetic hyperactivity: an under-recognized association?
Clinical Autonomic Research
Volume 23, Issue 2 , pp 109-111
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- 1. Department of Neurology and Neurocritical Care, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, CR-127, Portland, OR, 97239, USA
- 2. Brain Injury Rehabilitation Service, Westmead Hospital, University of Sydney, Sydney, Australia