A new case of psychotic break as the presenting symptom of anti-NMDA receptor encephalitis. Treatment from a neuropsychiatric approach
*Correspondencia: Dra. Pilar Hernáez Goñi. Complejo Hospitalario de Navarra. Fundacion Argibide., Elcano, Espana.
E-mail: pilar.hernaez.goni@navarra.es
Introduction. Limbic encephalitis generated by anti-N-methyl D-aspartate (NMDA) receptor antibodies is a severe acute
neurological condition that is more prevalent in young females and is associated with an underlying tumour. The
appearance of severe initial psychiatric signs and symptoms and the fact that it is accompanied by emotional disorders
and severe cognitive impairment make it necessary to reconsider the contributions of neuropsychiatry to the diagnosis,
development and treatment of the disease, since these have received little attention from researchers to date.
Case report. We report on what is, to our knowledge, the only case in Navarra, associated with an ovarian teratoma, with
special attention paid to its assessment, intervention and neuropsychiatric development.
Conclusion. Anti-NMDA receptor encephalitis is a disease that is usually accompanied by predominant psychiatric
manifestations at the outset of the illness, together with cognitive deterioration that commonly affects memory and the
executive functions. Treatment consisting in beginning a process of rehabilitation that includes compensatory strategies
for deficits, cognitive stimulation and psychopharmacological treatment in the recovery phase has proved to be effective.
Caso clínico Se presenta el único caso del que se tiene constancia en Navarra, asociado a un teratoma ovárico, atendiendo especialmente a la evaluación, la intervención y la evolución neuropsiquiátrica.
Conclusión La encefalitis antirreceptor de NMDA es una enfermedad que suele cursar con manifestaciones psiquiátricas predominantes en el inicio de la enfermedad, así como con deterioro cognitivo que afecta habitualmente a la memoria y a las funciones ejecutivas. Se demuestra eficaz iniciar un proceso de rehabilitación que incluya estrategias compensatorias del déficit, estimulación cognitiva y tratamiento psicofarmacológico en la fase de recuperación.
