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allied
academies
Nov 12-13, 2018 | Paris, France
Nutraceuticals and Food Sciences
International Conference on
27
th
International Conference on
Nursing and Healthcare
&
Joint Event
Journal of Food science and Nutrition | Volume 1
Don’t call me ‘madman’- The curse of anti-nmda receptor encephalitis
Chiu Ping Cho
Chi Mei Medical Center, Taiwan
A
nti-NMDA receptor encephalitis is an autoimmune disorder
that was discovered in 2005. It generates antibodies to
attack NMDA receptors and leads to acute encephalitis. It can
be lethal in severe cases. In the past, the confirmed cases were
mostly adults, but in recent years, children and teenagers with
definitive diagnoses were found in clinical practices. However,
some of the patients were erroneously sent to psychiatry
departments for treatment due to their psychological
symptoms, and thus missed the golden opportunity to recover.
Methods:
A 25-year old female without any special medical
history displayed stress-induced mental illness, incontinence
and auditory hallucinations since her father passed away. Her
symptoms were not improved after receiving treatment in other
hospitals. She came to our hospital for medical assistance after
she developed shortness of breath and local facial convulsions.
The examination results showed no abnormalities in lumbar
puncture, however the EEG demonstrated abnormal electrical
discharge from the brain. The MRI report indicated high frontal
lobe and basal ganglia swelling and encephalitis. After consulting
with the Department of Nephrology, the existence of an intra-
abdominal tumor (teratoma) as well as NMDA antibody-induced
encephalitis was suspected. The patient was then given proper
nursing care measures to address her issues (e.g. changes
in brain perfusion, less-effective breathing pattern, physical
disability and intense relationship with the caregiver).
Results:
After a one and a half-month effort by the
interdisciplinary medical team (the combination of the
Department of Neurology, Psychiatry, Nephrology, Oncology
and Gynecology), the patient received steroid therapy and
immunotherapy, oophorectomy and 7 times of therapeutic
hemapheresis (at her own expense). Under the good care of
the interdisciplinarymedical team(including theoccupational
therapist, dietitian, respiratory therapist, hemodialysis nurse,
ICUandwardnurses),herconditionfinallyreturnedtonormal.
Conclusion:
Anti-NMDAR encephalitis is a rare disease, but
is also the most common autoimmune encephalitis. As more
cases have been reported as of late, relevant information and
treatment have been further discussed, thus bring patients
and their families new hope. This study aims to remind
healthcare professionals that for patients without any previous
history of mental illness, if he/she displays flu-like symptoms
combined with a rapid progression of behavioral abnormalities,
neurological examination must be performed as early as
possible to further confirm the possibility of anti-NMDAR
encephalitis and thus provide proper treatment in time.
Keywords:
Anti-NMDAR encephalitis, autoimmune disorder,
teratoma.
e:
otocupid@ms26.hinet.net