Throughout the ages, convulsions, contortions of the body and face, including the tongue, super-human strength, catatonic periods, long periods of wakefulness or sleep, insensitivity to pain, speaking in tongues, and a predilection for self-injurious behaviours have all been offered as physical evidence of possession. The modern day interpretation, however, comes with a plot twist befitting a media spectacle. There is growing consensus in the medical community that many prior accounts of “demonic possession” may have represented original accounts of what is now broadly known as autoimmune encephalitis.
Emerging psychiatric syndromes associated with antivoltage-gated potassium channel complex antibodies Prüss H, Lennox BR. JNNP 2016; 87:1242-1247 Abstract Antibodies against the voltage-gated potassium channel (VGKC) were first recognised as having a potential pathogenic role in disorders of the central nervous system in 2001, with VGKC antibodies described in patients with limbic encephalitis, and the subsequent…
Since the recognition of antibodies against voltage - gated potassium channel (VGKC) and their pathogenic implication in central nervous system disorders (such as limbic encephalitis) in 2001, critical immunological and neurological advances have been achieved during the last 15 years.
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare condition characterized by emotional and behavioral disturbances, dyskinesias, and extrapyramidal signs. It occurs in young women of reproductive age and is classically described as a paraneoplastic phenomenon. We present a 36-year-old, HIV-positive female who was admitted to the hospital in an acute confusional state, with a stiff posture, periods of motor agitation, and myoclonic jerks of the hands. Her mental state progressively deteriorated. Without evidence of infection, the presence of anti-NMDAR antibodies both in serum and cerebrospinal fluid clinched the diagnosis of autoimmune encephalitis. No evidence of neoplastic disease was found, and the beneficial response to immunosuppressive therapy was exceptional. This is the first report of anti-NMDAR encephalitis in an HIV-infected individual, reminding us that autoimmune encephalitis should be included in the differential diagnosis of a young patient presenting in an acute confusional state. Case Rep Neurol 2016;8:251–257
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