Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakológiai Egyesület lapja = official journal of the Hungarian Association of Psychopharmacology
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Neuropsychopharmacol Hung · Mar 2018
[N-methyl-D-aspartate receptor antibody encephalitis: the Janus-faced disorder].
The recognition of the antibody-mediated encephalitis as a separate entity among the immune disorders of the central nervous system was one of the greatest breakthroughs of the last two decades in neurology. Unlike viral or tumor-related encephalitis, the antibody-mediated form has a good response to immunotherapy, which gives a special clinical importance to the discovery. Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is one of the first fully characterized antibody-mediated encephalitises. ⋯ Haloperidol is the most potent drug to treat the psychotic symptoms of the cortical phase; however due to its antidopaminergic side effect atypical neuroleptics are recommended by the experts. The immunological treatment is the administration of intravenous corticosteroid combined with plasma exchange or with intravenous IgG infusion. The immunotherapy in most of the cases is successful, but the recovery is long and it requires strong cooperation between the psychiatrists, neurologists and intensive care therapists.