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N. Warren, D. Siskind, and O. Psychiatrique, Refining the psychiatric syndrome of anti-N-methyl-d-aspartate receptor encephalitis. Acta Psychiatrica VII.2 Article version traduite, 2018.

, Les présentations psychiatriques d'encéphalite anti-récepteurs-NMDA (anti-NMDARe) peuvent entraîner un retard de diagnostic et un traitement inefficace

. Warren, Un niveau anormalement élevé d'effets secondaires est décrit avec les antipsychotiques. L'utilisation d'antiépileptiques n'est pas signalée de façon uniforme, bien que l'on puisse observer une manie aiguë et un état d'humeur mixte dans la maladie, 2018.

, Pour ce faire, nous présentons le cas d'une femme de 26 ans dont le diagnostic d'anti-NMDARe a été retardé par le valproate

, Elle a été hospitalisée pour un premier épisode maniaque rapide. La tomodensitométrie crânienne et les analyses sanguines habituelles étaient normales

, Elle n'a pas obtenu de réponse clinique avec plusieurs antipsychotiques prescrits aux doses habituelles. Des effets secondaires graves, dont le syndrome extra-pyramidal

, La récupération a été obtenue après dix jours avec du valproate à raison de 2000 mg/j. Il est à noter qu'elle a rapporté plus tard avoir souffert d'une désorientation spatiale brutale quelques jours avant l'hospitalisation et d'une amnésie totale par la suite

, Ceci explique des propriétés thérapeutiques et neuroprotectrices intéressantes dans l'anti-NMDARe mais qui pourraient retarder son diagnostic

, Ce cas démontre que le valproate soulage les symptômes psychiatriques secondaires et ralentit l'évolution clinique de l'anti-NMDARe, ce qui conduit à un diagnostic erroné de trouble bipolaire

. Mots-clés-n-méthyl-d-aspartate, auto-immune ; encéphalite ; valproate FINANCEMENT Le ou les auteurs n'ont reçu aucune aide financière pour la recherche

D. De-conflits-d'intérêts,

, Les auteurs n'ont déclaré aucun conflit d'intérêts potentiel en ce qui concerne la recherche, la qualité d'auteur et/ou la publication de cet article

L. Le,

D. C. Lagace, O. Timothy, W. Brien, and N. Gurvich, Valproic acid: how it works. Or not, Clinical Neuroscience Research, vol.4, issue.3-4, pp.215-225, 2004.

M. Manto, J. Dalmau, and A. Didelot, In vivo effects of antibodies from patients with anti-NMDA receptor encephalitis: further evidence of synaptic glutamatergic dysfunction, Orphanet Journal of Rare Diseases, vol.5, p.31, 2010.
URL : https://hal.archives-ouvertes.fr/inserm-00670158

N. Warren, D. Siskind, O. 'gorman, and C. , Refining the psychiatric syndrome of anti-N-methyl-d-aspartate receptor encephalitis, Acta Psychiatrica Scandinavica, 2018.

, Encéphalite limbique -caractéristiques cliniques et réponse au traitement selon les anticorps et la localisation des antigènes Iconographie issue de Dalmau J, Rosenfeld MR. Paraneoplastic syndromes of the CNS, Lancet Neurol, vol.7, issue.4, pp.327-367, 2008.

. Résumé,

, L'encéphalite limbique à anticorps anti-récepteurs N-Méthyl-D-Aspartate a été décrite pour la première fois en 2007 et se trouve au croisement des spécialités de neurologie et de psychiatrie

, Elle se manifeste principalement par un tableau d'allure psychiatrique avec une symptomatologie floride et inégale selon les patients. Son diagnostic est difficile et l'un des défis réside dans l'obtention précoce des soins appropriés pour les patients

, La revue de la littérature et la présentation de cas cliniques illustrent les différents enjeux, notamment thérapeutiques, de la prise en charge

, L'ensemble des données recueillies permet de discuter des facteurs contribuant au retard diagnostic dans la maladie

, Le médecin psychiatre semble alors avoir un rôle primordial dans la prévention de ce retard

, Ce travail a pour principal objectif d'apporter des précisions sur cette pathologie organique à expression psychiatrique afin de faciliter l'exercice des praticiens amenés à prendre en charge ces patients

. Mots-clés-encéphalite-anti-n-méthyl-d-aspartate,