The Phenomenology of Anti-NMDA Receptor Encephalitis: A Comparison with "Primary Mental Confusion" in Late 19th Century French Psychiatry.
Ryo Kato, Ryo Takenaka, Takuya Matsumoto
Frontiers in bioscience April 1, 2022 DOI: 10.31083/j.fbl2704116 via PubMed
Summary
AI-generated from the abstractAnalysis of 47 case reports of anti-NMDA receptor encephalitis supports the clinical course previously proposed by Iizuka et al. Common features include prodromal cold-like symptoms (31.9%), delirium or acute confusional state (65.9%), sudden personality changes (40.4%) in the psychotic phase, central hypoventilation (14.9%) in the unresponsive phase, motor disturbances (57.4%), and autonomic symptoms without fluctuations (48.9%) in the hyperkinetic phase. These features resemble "primary mental confusion" (confusion mentale primitive) described in French psychiatry in the late 19th century. The authors argue that classical psychiatric concepts can meaningfully inform the interpretation of biological research findings.
Study at a glance
| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 47 |
| Population | Patients with anti-NMDA receptor encephalitis |
| Topics | Philosophy of mind |
| Keywords | Anti-nmda receptor encephalitis History of psychiatry Schizophrenia |
| Key finding | The clinical course of anti-NMDA receptor encephalitis aligns with Iizuka et al.'s proposed stages and resembles the 19th-century French psychiatric concept of primary mental confusion. |
Abstract
Although various studies have been conducted on anti-NMDA receptor encephalitis since it was first reported in 2007, few studies have closely examined its clinical course. We analyzed 47 case reports of anti-NMDA receptor encephalitis that detailed its clinical course. The results of our study supported the clinical course proposed by Iizuka et al. From the results, it is suggested that the phenomenological features understood as indicative of anti-NMDA receptor encephalitis include: (1) antecedent common cold-like symptoms (31.9%) in the prodromal phase, (2) delirium or acute confusional state (65.9%), (3) symptoms considered to be sudden personality changes (40.4%) in the psychotic phase, (4) central hypoventilation (14.9%) in the unresponsive phase, (5) motor disturbances (57.4%), and (6) autonomic symptoms, mainly without fluctuations (48.9%), in the hyperkinetic phase. These features were found to be similar to "primary mental confusion" (confusion mentale primitive) in French psychiatry in the late 19th century. We believe that classical psychiatry can contribute considerably to the interpretation of biological research results.