The distinct movement disorder in anti-NMDA receptor encephalitis may be related to Status Dissociatus: a hypothesis.
Identifieur interne : 000B83 ( Main/Exploration ); précédent : 000B82; suivant : 000B84The distinct movement disorder in anti-NMDA receptor encephalitis may be related to Status Dissociatus: a hypothesis.
Auteurs : Maria Stamelou [Royaume-Uni] ; Giuseppe Plazzi ; Elio Lugaresi ; Mark J. Edwards ; Kailash P. BhatiaSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2012.
English descriptors
- KwdEn :
- Anti-N-Methyl-D-Aspartate Receptor Encephalitis (blood), Anti-N-Methyl-D-Aspartate Receptor Encephalitis (complications), Anti-N-Methyl-D-Aspartate Receptor Encephalitis (diagnosis), Dissociative Disorders (etiology), Eye Movements (physiology), Humans, Movement Disorders (complications), Movement Disorders (diagnosis).
- MESH :
- blood : Anti-N-Methyl-D-Aspartate Receptor Encephalitis.
- complications : Anti-N-Methyl-D-Aspartate Receptor Encephalitis, Movement Disorders.
- diagnosis : Anti-N-Methyl-D-Aspartate Receptor Encephalitis, Movement Disorders.
- etiology : Dissociative Disorders.
- physiology : Eye Movements.
- Humans.
Abstract
The majority of patients with anti-N-methyl-D-aspartate-receptor encephalitis (NMDAE) present a characteristic movement disorder, which consists of complex bilateral stereotyped movements of the arms, with perioral and eye movements, and less frequently involvement of the legs. We have observed striking similarities in the characteristics of the abnormal movements observed in NMDAE and those described in Status Dissociatus, which is characterized by a complete breakdown of state-determining boundaries (wakefulness, REM and NREM sleep) and can result from pathophysiologically diverse disorders (e.g. fatal familial insomnia, delirium tremens, Morvan's syndrome). Here, we suggest that the state of paradoxical responsiveness in which NMDAE patients present these stereotyped movements may be that of Status Dissociatus and discuss the clinical similarities and pathophysiological explanations that support such a suggestion. This hypothesis explains why patients that seem to be unconscious have a movement disorder that is not epileptic and may have management implications, since many patients with NMDAE-related movement disorder are treated with anticonvulsants that may not be indicated.
DOI: 10.1002/mds.25072
PubMed: 22700398
Affiliations:
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Edwards</name></author><author><name sortKey="Bhatia, Kailash P" sort="Bhatia, Kailash P" uniqKey="Bhatia K" first="Kailash P" last="Bhatia">Kailash P. 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Edwards</name></author><author><name sortKey="Bhatia, Kailash P" sort="Bhatia, Kailash P" uniqKey="Bhatia K" first="Kailash P" last="Bhatia">Kailash P. Bhatia</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anti-N-Methyl-D-Aspartate Receptor Encephalitis (blood)</term><term>Anti-N-Methyl-D-Aspartate Receptor Encephalitis (complications)</term><term>Anti-N-Methyl-D-Aspartate Receptor Encephalitis (diagnosis)</term><term>Dissociative Disorders (etiology)</term><term>Eye Movements (physiology)</term><term>Humans</term><term>Movement Disorders (complications)</term><term>Movement Disorders (diagnosis)</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Anti-N-Methyl-D-Aspartate Receptor Encephalitis</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Anti-N-Methyl-D-Aspartate Receptor Encephalitis</term><term>Movement Disorders</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Anti-N-Methyl-D-Aspartate Receptor Encephalitis</term><term>Movement Disorders</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dissociative Disorders</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Eye Movements</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The majority of patients with anti-N-methyl-D-aspartate-receptor encephalitis (NMDAE) present a characteristic movement disorder, which consists of complex bilateral stereotyped movements of the arms, with perioral and eye movements, and less frequently involvement of the legs. We have observed striking similarities in the characteristics of the abnormal movements observed in NMDAE and those described in Status Dissociatus, which is characterized by a complete breakdown of state-determining boundaries (wakefulness, REM and NREM sleep) and can result from pathophysiologically diverse disorders (e.g. fatal familial insomnia, delirium tremens, Morvan's syndrome). Here, we suggest that the state of paradoxical responsiveness in which NMDAE patients present these stereotyped movements may be that of Status Dissociatus and discuss the clinical similarities and pathophysiological explanations that support such a suggestion. This hypothesis explains why patients that seem to be unconscious have a movement disorder that is not epileptic and may have management implications, since many patients with NMDAE-related movement disorder are treated with anticonvulsants that may not be indicated.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Bhatia, Kailash P" sort="Bhatia, Kailash P" uniqKey="Bhatia K" first="Kailash P" last="Bhatia">Kailash P. Bhatia</name><name sortKey="Edwards, Mark J" sort="Edwards, Mark J" uniqKey="Edwards M" first="Mark J" last="Edwards">Mark J. Edwards</name><name sortKey="Lugaresi, Elio" sort="Lugaresi, Elio" uniqKey="Lugaresi E" first="Elio" last="Lugaresi">Elio Lugaresi</name><name sortKey="Plazzi, Giuseppe" sort="Plazzi, Giuseppe" uniqKey="Plazzi G" first="Giuseppe" last="Plazzi">Giuseppe Plazzi</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Stamelou, Maria" sort="Stamelou, Maria" uniqKey="Stamelou M" first="Maria" last="Stamelou">Maria Stamelou</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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