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PSYCHIATRIC PRESENTATIONS OF AUTOANTIBODY-MEDIATED ENCEPHALITIS
  1. Rachael Matthews1,2,
  2. Richard Hackett1,
  3. Matthew Jones1
  1. 1Greater Manchester Neurosciences Centre, Salford Royal Foundation NHS Trust
  2. 2Manchester Medical School, University of Manchester

Abstract

Background Antibody-mediated limbic encephalitis refers to a spectrum of inflammatory neurological disease. Patients typically have a syndrome consisting of disorientation, amnesia, seizures and behavioural change. Autonomic disturbance and movement disorders are also observed. There has been recent interest in the potential role of autoantibodies in patients with psychosis without the other clinical features of limbic encephalitis.

Aims To characterise the clinical phenotype of patients presenting to a neuropsychiatry clinic with predominant psychosis and positive autoantibodies. We also aimed to determine if a standardised approach was being taken to their assessment.

Methods Retrospective case note review using a standardised proforma.

Results 20 patients were identified with prominent psychosis and positive autoantibodies (9 NMDAr, 7 VGKC, 3 GAD, 1 TPO). 7 patients had psychiatric symptoms only. 5 patients had additional clinical symptoms to suggest a diagnosis of limbic encephalitis. 8 patients had prominent psychosis symptoms and only very mild other associated neurological problems making them hard to classify. There was variability in the assessment that patients received.

Conclusions Pure psychiatric presentations in patients with positive autoantibodies are observed and further study is required to elucidate the role of such antibodies in the pathogenesis of these disorders.

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