USMLE Mistake Deck 3 Flashcards
Autoimmune encephalitis
Clinical Features: psychiatric symptoms ( anxiety, psychosis, insomnia), autonomic instability ( hyperthermia, HTN, tachycardia), cognitive impairment, rigidity, hyperreflexia, dystonia, and focal seizure after a flu like prodrome in the setting o know ovarian teratoma strongly suggest anti-NMDA receptor ( anti-NMDAR) encephalitis. This form of autoimmune encephalitis tends to present as a multistage syndrome with characteristic features. Anti-NMDAR encephalitis has a median age of 21, it is 4 times more common in women, of whom > 50% have an associated ovarian teratoma.
Clinical diangnosis may be confirmed by the presence of CSF antibodies to the GluN1 subunit of NMDAR. B/c of the association with tumors, pts with anti-NMDAR encephalitis should undergo imaging. If applicable, prompt tour removal has been associated with better outcomes. Regardless of the presence of a tumor, immunosuppressive treatment is the cornerstone of therapy. Recovery is often slow, but 4 of 5 pts recover with minimal sequelae within 2 yrs.
