Electroconvulsive therapy for anti-N-methyl-D-aspartate (NMDA) receptor encephalitis: A systematic review of cases
Electroconvulsive therapy for anti-N-methyl-D-aspartate (NMDA) receptor encephalitis: A systematic review of cases
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DOI：
10.1016/j.brs.2018.11.016
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发表时间：
2019-03-01
影响因子：
7.7
通讯作者：
Siskind, Dan
中科院分区：
文献类型：
--
作者：
Warren, Nicola;Grote, Vanessa;Siskind, Dan
背景：抗NMDA受体脑炎最常见的精神症状，如行为障碍，紧张症和精神病。虽然主要治疗是免疫调节治疗，精神症状往往需要辅助管理。目的：探讨ECT治疗抗NMDA受体脑炎的安全性和有效性。方法：应用PubMed、Embase和PsycInfo系统检索自2018年6月至2018年6月的30例抗NMDA受体脑炎患者的临床资料。病例通常为年轻（平均年龄27.7岁，SD 15.2）女性（73.3%）伴紧张症（86.7%）。这些症状在65.2%的病例中得到改善，有趣的是，在17.4%的病例中没有免疫调节治疗。86.7%的病例进行了ECT，无并发症，4例因脑炎进一步恶化而提前停止ECT。无麻醉并发症。结论：ECT是一种有效和安全的辅助治疗抗NMDA受体脑炎，特别是紧张症。(C)2018爱思唯尔公司All rights reserved.
Background: Anti-NMDA receptor encephalitis most commonly presents with psychiatric symptoms such as behavioural disturbance, catatonia and psychosis. Although the primary treatment is with immunomodulatory therapy, psychiatric symptoms often require adjuvant management. Side effects and treatment resistance limits the use of psychotropics, but the role of ECT has been minimally reviewed.Objective: To review the safety and effectiveness of ECT for treatment of psychiatric symptoms in anti-NMDA receptor encephalitis.Methods: A systematic literature review of PubMed, Embase and PsycInfo was performed from inception to June 2018.Results: There were 30 cases of ECT used in anti-NMDA receptor encephalitis. Cases were typically young (mean age 27.7 years, SD 15.2) females (73.3%) with catatonia (86.7%). There was improvement of these symptoms in 65.2% of cases, interestingly without immunomodulatory therapy in 17.4%. ECT proceeded without complication in 86.7% of cases, with four cases prematurely ceasing ECT with further encephalitic deterioration. There were no anaesthetic complications.Conclusions: ECT appears to be an effective and safe adjuvant treatment in anti-NMDA receptor encephalitis, particularly for catatonia. (C) 2018 Elsevier Inc. All rights reserved.