ANTIPSYCHOTICS IN ANTI-NMDAR ENCEPHALITIS BEFORE IMMUNOTHERAPY
Description
We included patients from the ANMDARE cohort at the National Institute of Neurology and Neurosurgery of Mexico (NINN) assessed between 2014 and 2022, who received psychiatric attention and symptomatic treatment with antipsychotic medications before the referral to our Institution, before a formal ANMDARE diagnosis, and before the administration of immunotherapy. All patients underwent a comprehensive diagnostic evaluation, including extensive bloodwork, EEG, MRI, and lumbar puncture studies, to exclude other potential causes, and to ascertain the presence of anti-NMDAR antibodies in cerebrospinal fluid (CSF). Patients were diagnosed as having possible, probable and definite autoimmune psychosis according to the Pollak et al criteria,4 and classified as having or not a significant adverse reaction to antipsychotic medication, raising the suspicion of NMS, according to the Pollak et al criteria, which consider three variables: hyperthermia, generalized rigidity, and elevation of CPK. A full diagnosis of NMS was done by means of the DSM-5 and the Caroff et al recommendations.
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Steps to reproduce
Descriptive statistics and normality tests, as well as inferential statistics, were obtained utilizing the SPSS software version 25. We compared patients with intolerance to antipsychotics, according to the criteria by Pollak et al (2019), with patients without intolerance to antipsychotics with the use of chi-square tests and Mann-Whitney tests