Antikörpervermittelte Enzephalitiden in der Psychiatrie

(Sub-)akut auftretende kognitive und psychische Störungen, neurologische Ausfälle, epileptische Anfälle und Veränderungen der Affektivität bei zuvor psychisch gesunden Menschen sollten an eine Enzephalitis denken lassen. Da wegen der Anfangssymptomatik die Erstvorstellung häufig bei einem Psychiater erfolgt, sollte dieser mit dem Krankheitsbild antikörpervermittelter Enzephalitiden vertraut sein. Denn die frühe Therapie bestimmt die Prognose.

Schlüsselwörter

Autoimmunenzephalitis - NMDA-Rezeptor - limbische Enzephalitis - onkoneuroale Antikörper

• Literatur

• 1 Zandi MS, Irani SR, Lang B. et al. Disease-relevant autoantibodies in first episode schizophrenia. J Neurol 2011; 258: 686-688
• 2 Lennox BR, Palmer-Cooper EC, Pollak T. et al. Prevalence and clinical characteristics of serum neuronal cell surface antibodies in first-episode psychosis: a case-control study. The Lancet Psychiatry 2017; 4: 42-48
• 3 Ando Y, Shimazaki H, Shiota K. et al. Prevalence of elevated serum anti-N-methyl-D-aspartate receptor antibody titers in patients presenting exclusively with psychiatric symptoms: a comparative follow-up study. BMC Psychiatry 2016; 16: 226
• 4 Steiner J, Walter M, Glanz W. et al. Increased prevalence of diverse N-methyl-D-aspartate glutamate receptor antibodies in patients with an initial diagnosis of schizophrenia: specific relevance of IgG NR1a antibodies for distinction from N-methyl-D-aspartate glutamate receptor encephalitis. JAMA Psychiatry 2013; 70: 271-278
• 5 de Witte LD, Hoffmann C, van Mierlo HC. et al. Absence of N-Methyl-D-aspartate receptor IgG autoantibodies in schizophrenia: The importance of cross-validation studies. JAMA Psychiatry 2015; 72: 731-733
• 6 Masdeu JC, Gonzalez-Pinto A, Matute C. et al. Serum IgG antibodies against the NR1 subunit of the NMDA receptor not detected in schizophrenia. Am J Psychiatry 2012; 169: 1120-1121
• 7 Masopust J, Andrýs C, Bazant J. et al. Anti-NMDA receptor antibodies in patients with a first episode of schizophrenia. Neuropsychiatr Dis Treat 2015; 11: 619-623
• 8 Dahm L, Ott C, Steiner J. et al. Seroprevalence of autoantibodies against brain antigens in health and disease. Ann Neurol 2014; 76: 82-94
• 9 Pollak TA, McCormack R, Peakman M. et al. Prevalence of anti-N-methyl-D-aspartate (NMDA) receptor [corrected] antibodies in patients with schizophrenia and related psychoses: a systematic review and meta-analysis. Psychol Med 2014; 44: 2475-2487
• 10 Doss S, Wandinger KP, Hyman BT. et al. High prevalence of NMDA receptor IgA/IgM antibodies in different dementia types. Ann Clin Translat Neurol 2014; 1: 822-832
• 11 Ramanathan S, Mohammad SS, Brilot F. et al. Autoimmune encephalitis: recent updates and emerging challenges. J Clin Neurosci 2014; 21: 722-730
• 12 Dalmau J, Tuzun E, Wu HY. et al. Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol 2007; 61: 25-36
• 13 Prüss H. Neuroimmunology: New developments in limbic encephalitis. Aktuel Neurol 2013; 40: 127-136
• 14 Darnell RB, Posner JB. Paraneoplastic syndromes affecting the nervous system. Seminars Oncol 2006; 33: 270-298
• 15 Bost C, Pascual O, Honnorat J. Autoimmune encephalitis in psychiatric institutions: current perspectives. Neuropsychiatr Dis Treat 2016; 12: 2775-2787
• 16 Dalmau J, Lancaster E, Martinez-Hernandez E. et al. Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. Lancet Neurol 2011; 10: 63-74
• 17 Bien C. Immunvermittelte Erkrankungen der grauen ZNS-Substanz sowie Neurosarkoidose. In: Diener HC, Weimar C. Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie. Stuttgart: Thieme; 2012: 476-487
• 18 Lejuste F, Thomas L, Picard G. et al. Neuroleptic intolerance in patients with anti-NMDAR encephalitis. Neurology(R) Neuroimmunol Neuroinflamm 2016; 3: e280
• 19 Kayser MS, Titulaer MJ, Gresa-Arribas N. et al. Frequency and characteristics of isolated psychiatric episodes in anti-N-methyl-d-aspartate receptor encephalitis. JAMA Neurol 2013; 70: 1133-1139
• 20 van Sonderen A, Schreurs MW, Wirtz PW. et al. From VGKC to LGI1 and Caspr2 encephalitis: The evolution of a disease entity over time. Autoimmunity Rev 2016; 15: 970-974
• 21 Vincent A, Buckley C, Schott JM. et al. Potassium channel antibody-associated encephalopathy: a potentially immunotherapy-responsive form of limbic encephalitis. Brain 2004; 127: 701-712
• 22 Leypoldt F. Paraneoplastische neurologische Syndrome. In: Diener HC, Weimar C. Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie. Stuttgart: Thieme; 2012: 966-978
• 23 Irani SR, Gelfand JM, Al-Diwani A. et al. Cell-surface central nervous system autoantibodies: clinical relevance and emerging paradigms. Ann Neurol 2014; 76: 168-184
• 24 Carvalho F, Massano J, Coelho R. Neuropsychiatric symptoms in autoimmune encephalopathies: a clinicianʼs guide. Int J Clin Neurosci Mental Health 2014; 1
• 25 Gresa-Arribas N, Titulaer MJ, Torrents A. et al. Antibody titres at diagnosis and during follow-up of anti-NMDA receptor encephalitis: a retrospective study. Lancet Neurol 2014; 13: 167-177
• 26 Darnell RB, Posner JB. A new cause of limbic encephalopathy. Brain 2005; 128: 1745-1746
• 27 Irani SR, Michell AW, Lang B. et al. Faciobrachial dystonic seizures precede Lgi1 antibody limbic encephalitis. Ann Neurol 2011; 69: 892-900
• 28 Kuppuswamy PS, Takala CR, Sola CL. Management of psychiatric symptoms in anti-NMDAR encephalitis: a case series, literature review and future directions. General Hosp Psychiatry 2014; 36: 388-391
• 29 Graus F, Boronat A, Xifro X. et al. The expanding clinical profile of anti-AMPA receptor encephalitis. Neurology 2010; 74: 857-859
• 30 Dalakas MC, Fujii M, Li M. et al. The clinical spectrum of anti-GAD antibody-positive patients with stiff-person syndrome. Neurology 2000; 55: 1531-1535
• 31 Stich O, Rauer S. [Paraneoplastic neurological syndromes and autoimmune encephalitis]. Nervenarzt 2014; 85: 485-498 quiz 499–501
• 32 Arino H, Hoftberger R, Gresa-Arribas N. et al. Paraneoplastic neurological syndromes and glutamic acid decarboxylase antibodies. JAMA Neurol 2015; 72: 874-881
• 33 Sunwoo JS, Chu K, Byun JI. et al. Intrathecal-specific glutamic acid decarboxylase antibodies at low titers in autoimmune neurological disorders. J Neuroimmunol 2016; 290: 15-21