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Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis

Published on: July 4, 2007

[ECT in autoimmune encephalitis].

Håkon Olafsen Waaler¹, Thomas Harbo

¹haawaa@rm.dk.

Ugeskrift for Laeger

|January 25, 2021

Summary

This summary is machine-generated.

This case report highlights a patient with anti-N-methyl-D-aspartate (NMDA) receptor autoimmune encephalitis who experienced severe catatonia. Electroconvulsive therapy (ECT) effectively resolved psychotic and behavioral symptoms, suggesting its utility in managing this neurological condition.

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Area of Science:

Neurology
Neuroimmunology
Psychiatry

Background:

Anti-N-methyl-D-aspartate (NMDA) receptor autoimmune encephalitis is a severe neuropsychiatric disorder.
Catatonia is a complex neuropsychiatric syndrome that can manifest in various neurological and psychiatric conditions.
Treatment-resistant catatonia poses significant management challenges.

Observation:

A 27-year-old male with postherpetic anti-NMDA receptor autoimmune encephalitis presented with psychotic symptoms and severe akinetic and excited catatonia.
The patient exhibited violent behavior requiring mechanical restraint for 46 days.
Standard pharmacological treatments (olanzapine, lorazepam) were ineffective in managing the catatonic and behavioral symptoms.

Findings:

Electroconvulsive therapy (ECT) was initiated for the patient's catatonia.
The patient received 16 ECT treatments.
Complete resolution of violent behavior occurred after the first ECT treatment, indicating a rapid and positive response.

Implications:

ECT should be strongly considered as a treatment option for catatonia associated with anti-NMDA receptor autoimmune encephalitis.
This case underscores the potential efficacy of ECT in managing severe, treatment-refractory catatonia in the context of autoimmune encephalitis.
Further research into the role of ECT in autoimmune-mediated catatonia is warranted.