:Introduction:Anti-NMDA (N-methyl-D-aspartate) receptor encephalitis often presents itself in psychiatric settings as first-break psychosis. I present a case of a 31-year-old female who returned to the clinic one year after being treated for NMDA receptor antibody encephalitis.CASE REPORT:Ms. C is a 31 y/o female who returned to the clinic after one year of being discharged from the hospital for NMDA-receptor encephalitis with positive serological NR1 antibodies. She was initially admitted to our inpatient psychiatric facility for an unspecified psychotic disorder complicated with seizure-like episodes. She was given various psychotropic medications without any improvement. She was moderately responsive to olanzapine and lorazepam. Her condition gradually worsened; she stopped communicating and became mute. Neurology consultation prompted work-up for encephalitis and the probable diagnosis of NMDA receptor encephalitis. She was subsequently treated with steroids, IVIG and then intrathecal rituximab and bortezomib. In addition to these aforementioned medications, she underwent a prophylactic oophorectomy and 10 ECT treatments for life threatening catatonia. After three weeks of this regimen, Ms. C recovered completely and was discharged home.DISCUSSION:This case adds to literature that suggests prompt diagnosis and management of NMDA receptor encephalitis significantly improves prognosis. Treatment should be initiated if the patient meets probable diagnostic criteria for NMDA receptor encephalitis. Similar to other cases in the literature, our patient’s symptom of catatonia improved with ECT administration. During Ms. C one year follow-up, no evidence of psychotic symptoms were appreciated. Family members reported that she had returned to her baseline cognitive function.

中文翻译：

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133 中毒性精神病：治疗一年后的随访

:Introduction:抗 NMDA（N-甲基-D-天冬氨酸）受体脑炎在精神病学环境中通常表现为初发精神病。我介绍了一名 31 岁女性的病例，她在接受 NMDA 受体抗体脑炎治疗一年后返回诊所。病例报告：Ms. C 是一名 31 岁的女性，她因 NMDA 受体脑炎出院一年后返回诊所，血清学 NR1 抗体呈阳性。她最初因一种未指明的精神病性障碍并发癫痫样发作而被送入我们的住院精神病院。她服用了各种精神药物，但没有任何改善。她对奥氮平和劳拉西泮有中度反应。她的病情逐渐恶化；她停止了交流，变得沉默了。神经内科会诊提示对脑炎的检查和 NMDA 受体脑炎的可能诊断。随后她接受了类固醇、IVIG 和鞘内注射利妥昔单抗和硼替佐米的治疗。除了上述这些药物外，她还接受了预防性卵巢切除术和 10 次 ECT 治疗以治疗危及生命的紧张症。该方案治疗三周后，C女士完全康复出院回家。讨论：该病例增加了文献，表明及时诊断和管理NMDA受体脑炎可显着改善预后。如果患者符合 NMDA 受体脑炎的可能诊断标准，则应开始治疗。与文献中的其他病例相似，我们患者的紧张症症状在 ECT 给药后得到改善。在C女士一年的随访中，没有发现精神病症状的证据。家庭成员报告说她已经恢复到她的基线认知功能。