Psikotik Belirtilerin ve Nöbetlerin Eşlik Ettiği Ensefalit Hastasının Klinik Yönetimi: Olgu Sunumu

Öz

Ensefalit baş ağrısı, ateş, mide bulantısı, kusma, bilinç durumunda dalgalanma ve uyku- uyanıklık döngüsünün bozulması gibi bulguların eşlik edebildiği, beyin dokusunun infl amasyonu ile karakterize klinik bir tablodur. Ensefalit etiyolojisinde yer alan nedenlerden biri olan otoimmunite temelli N-metil-D-aspartat NMDA reseptör ensefaliti; hastaların yaklaşık %77’sinde nöropsikiyatrik belirtilerin eşlik etmesi ve klinikte ilk başvurunun psikiyatri hekimine olması nedeniyle psikiyatrinin ilgi alanına da girmektedir. Erken dönemde müdahale edilmediği takdirde ölüm oranlarının yüksek olması sebebiyle Anti NMDA-R ensefaliti tedavisinde hedef, hem psikotik belirtilerin hem de diğer klinik durumların düzeltilmesini içermelidir. Bu olgu bildiriminde, psikotik belirtilerin ve epileptik nöbetlerin eşlik ettiği Anti-NMDAR ensefalitli hastanın, tanıdan tedaviye klinik yönetiminde dikkat edilmesi gereken etmenlerin ve bu süreçte karşılaşılan güçlüklerin ele alınması amaçlanmıştır

Anahtar Kelimeler

• Anti NMDA-R Ensefaliti, Psikotik belirti, Epileptik nöbet

The Clinical Management of the Psychotic Symptoms in a Patient with Encephalitis with Seizures: Case Report

Abstract

Encephalitis is an infl ammation of the brain tissue. Headache, fever, nausea, vomiting and confusion are the most common presenting symptoms of the disease. Anti N-methyl-D- aspartate NMDA receptor encephalitis is one of the autoimmune causes of encephalitis where 77% of patients suffer from neuropsychiatric symptoms. Psychiatrists are interested in Anti-NMDA-R encephalitis because it is well known that autoimmune encephalitis is associated with psychiatric symptoms. Anti NMDA-R encephalitis is associated with high rates of mortality and morbidity despite treatment. The management of the clinical features is very important in these patients because of the high rate of death in the early stages. In this paper, we aimed to report the management of the clinical features of a case with Anti NMDA-R encephalitis presenting with seizures and psychotic symptoms

Keywords

• Anti NMDA-R Encephalitis, Psychotic symptoms, Seizure

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