Anti-N-Methyl d-Aspartate Receptor Encephalitis and Electroconvulsive Therapy: Literature Review and Future Directions

• Published in: Child and adolescent psychiatric clinics of North America Vol. 28; no. 1; p. 79
• Main Authors: Tanguturi, Yasas Chandra, Cundiff, Allyson Witters, Fuchs, Catherine
• Format: Journal Article
• Language: English
• Published: United States 01.01.2019
• Subjects: Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - immunology; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - therapy; Benzodiazepines - administration & dosage; Catatonia - etiology; Catatonia - therapy; Electroconvulsive Therapy - adverse effects; Electroconvulsive Therapy - methods; Humans; Seizures - etiology; Sleep Initiation and Maintenance Disorders - etiology; Catatonia; Electroconvulsive therapy; Anti-NMDA encephalitis; ECT; Autoimmune encephalitis
• ISSN: 1558-0490
• DOI: 10.1016/j.chc.2018.07.005

Despite the majority of patients with anti-N-methyl d-aspartate receptor (NMDAR) antibody encephalitis presenting with catatonic symptoms, the literature has not focused on well-known treatments for catatonia, such as electroconvulsive therapy (ECT). The authors review the literature identifying case reports that document the effective use of ECT for anti-NMDAR encephalitis. They also identify gaps in the literature regarding use and documentation of ECT and review possible mechanisms of action for ECT. The authors propose identifying catatonia as a syndrome with multiple potential causes (including anti-NMDAR encephalitis) and suggest a standardized treatment approach using evidence-based catatonia treatments such as ECT and benzodiazepines.