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Anti-NMDA receptor encephalitis presenting with total insomnia--a case report

dc.contributor.authorMarques, IB
dc.contributor.authorTeotónio, R
dc.contributor.authorCunha, C
dc.contributor.authorBento, C
dc.contributor.authorSales, F
dc.date.accessioned2017-08-23T10:51:33Z
dc.date.available2017-08-23T10:51:33Z
dc.date.issued2014-01-15
dc.description.abstractFatal insomnia (FI) is the first diagnosis to be considered by most neurologists when approaching a patient presenting with total insomnia followed by personality and cognitive changes, disturbance of alertness, autonomic hyperactivation and movement abnormalities. We report the case of a 30 year-old male patient who presented with total insomnia followed by episodes of psychomotor restlessness resembling anxiety attacks. Twenty days later, he developed refractory convulsive status epilepticus with admission to Intensive Care Unit. He progressed to a state of reduced alertness and responsiveness, presenting periods of agitation with abnormal dyskinetic movements, periods of autonomic instability and central hypoventilation. Workup revealed antibodies against N-methyl-d-aspartate receptor (NMDAR). Immunotherapy treatment led to a very significant improvement with the patient presenting only slight frontal lobe dysfunction after one year of recovery. To the best of our knowledge this is the first report of a patient with anti-NMDAR encephalitis first presenting with total insomnia. Our aim is to alert that anti-NMDAR encephalitis must be considered in the differential diagnosis of FI, especially in sporadic cases. Distinguishing the two conditions is very important as, contrarily to the fatal disclosure of FI, anti-NMDAR encephalitis is potentially reversible with adequate treatment even after severe and prolonged disease.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Neurol Sci. 2014 Jan 15;336(1-2):276-80.pt_PT
dc.identifier.doi10.1016/j.jns.2013.10.034pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.4/2054
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectEncefalite Antirreceptor de N-Metil-D-Aspartatopt_PT
dc.subjectDistúrbios da Iniciação e Manutenção do Sonpt_PT
dc.subjectMalept_PT
dc.titleAnti-NMDA receptor encephalitis presenting with total insomnia--a case reportpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage280pt_PT
oaire.citation.issue1-2pt_PT
oaire.citation.startPage276-80pt_PT
oaire.citation.volume336pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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