Psychotic Symptoms in Patients with Nmda Antibodies

Abstract

Introduction

This paper is a review of literature about the relation in some cases between psychotic symptoms and NMDA antibodies. Most of these cases are early observed and treated by psychiatry, observing torpid evolution and symptoms that are rarely observed in Psychiatry patients, like visual hallucinations or rapid fluctuations of symptoms.

Objectives

Make a review of psychotic symptoms and NMDA antibodies, to think about other options when we are in front of some unusual cases in psychiatry, and it seems that “nothing is working”

Methods

Systematic review of pub med literature, applying the keywords: “psychotic” and “NMDA antibodies” of last 5 years.

Results

We found that in most of cases the patients presents Opisthotonus, catatonia, and rhythmic and non-rhythmic involuntary movements of the mouth and jaw, and most of them had a psychiatric evaluation for those symptoms. There was no response to antipsicotic treatment. The treatment with corticoids and rituximab was effective.

Conclusions

In psychiatry we have to think in some cases that maybe “the patient could have something else than a psychiatric disease”, most when we found that the symptoms has a rare presentation and the treatment is not effective.

We encourage our colleagues to “think outside the box” when something like this occurs, and hesitate about our own valuations of the patients, when the case is atypical strange.

Disclosure of interest

The authors have not supplied their declaration of competing interest.