Clinical and Therapeutic Challenges when Psychiatric Disorders Occur in Neurological Diseases: A Narrative Review

Author(s): Antonio Callari, Mario Miniati*

Journal Name: Current Psychiatry Research and Reviews
Formerly: Current Psychiatry Reviews

Volume 15 , Issue 2 , 2019

Become EABM
Become Reviewer

Graphical Abstract:


Abstract:

Background: Over the course of the 20th century, neurology and psychiatry diverged and became two separate disciplines. Subsequently, the continuous progress of neurosciences confused their boundaries. However, with ‘the splitting’ and ‘the lumping’ approaches, relevant difficulties remain in targeting clinical and therapeutic goals, when psychiatric signs and symptoms co-occur with neurological diseases.

Objective: The study summarize current evidence on psychiatric signs and symptoms comorbid with neurological diseases, with the aim to provide information on diagnostic problems and available therapeutic options.

Methods: Finding from searches of publications on ‘PsycInfo’, ‘Medline’, and ‘Science Direct’, from January 1993 to December 2018 (25 years) is summarized in a narrative manner on six main neurological areas: congenital neurological illnesses (n=16), dementias (n=15), basal ganglia diseases (n=30), epilepsy (n=22), strokes/focal brain injuries (n=29), and neurological neoplastic/paraneoplastic diseases (n=15).

Results: Clinical phenotypes of psychiatric syndromes are frequently described in neurological studies. Little evidence is provided on the most adequate therapeutic approaches.

Conclusion: Psychiatric syndromes in comorbidity with neurological diseases are heterogeneous and severe; evidence-based treatments are scarce. Despite a model supporting an equal approach between psychiatric and neurological syndromes, psychiatric syndromes in neurological diseases have been described, to a relevant degree, as less important, leading to a hierarchical primate of the neurological manifestations, and thus, in our opinion, limiting the systematic studies on psychopharmacological treatments in this area.

Keywords: Neuropsychiatry, psychiatric disorders, neurological diseases, comorbidity, psychopharmacological, neurosciences.

[1]
Downar J, Blumberger DM, Daskalakis ZJ. The neural crossroads of psychiatric illness: an emerging target for brain stimulation. Trends Cogn Sci 2016; 20(2): 107-20.
[2]
Crossley NA, Scott J, Ellison-Wright I, et al. Neuroimaging distinction between neurological and psychiatric disorders. Br J Psychiatry 2015; 207(5): 429-34.
[3]
Cross-Disorder Group of the Psychiatric Genomics Consortium. Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis Lancet 2013; 20; 381(9875): 1371-9
[4]
Silver JM. Behavioral neurology neuropsychiatry is a subspecialty. J Neuropsychiatry Clin Neurosci 2006; 18(2): 146-8.
[5]
Kaufman DM, Geyer HL, Milstein MJ. Congenital Cerebral Impairments.In: Kaufman’s Clinical Neurology for Psychiatrists E-Book Amsterdam. Elsevier Health Sciences 2016; pp. 281-94.
[6]
Kozinetz CA, Skender ML, MacNaughton N, et al. Epidemiology of Rett syndrome: a population-based registry. Pediatrics 1993; 91(2): 445-50.
[7]
Amir RE, Van den Veyver IB, Wan M, Tran CQ, et al. Rett syndrome is caused by mutations in X-linked MECP2, encoding methyl-CpG-binding protein 2. Nat Genet 1999; 23(2): 185-8.
[8]
Zappella M, Meloni I, Longo I, et al. Preserved speech variants of the Rett syndrome: molecular and clinical analysis. Am J Med Genet 2001; 104(1): 14-22.
[9]
Cornish K, Turk J, Hagerman R. The fragile X continuum: new advances and perspectives. J Intellect Disabil Res 2008; 52(Pt 6): 469-82.
[10]
Moss J, Howlin P. Autism spectrum disorders in genetic syndromes: implications for diagnosis, intervention and understanding the wider autism spectrum disorder population. J Intellect Disabil Res 2009; 53(10): 852-73.
[11]
Sullivan K, Hatton D, Hammer J, et al. ADHD symptoms in children with FXS. Am J Med Genet A 2006; 140(21): 2275-88.
[12]
Savic I. Advances in research on the neurological and neuropsychiatric phenotype of Klinefelter syndrome. Curr Opin Neurol 2012; 25(2): 138-43.
[13]
Bruining H, Swaab H, Kas M, et al. Psychiatric characteristics in a self-selected sample of boys with Klinefelter syndrome. Pediatrics 2009; 123(5): 865-70.
[14]
Strous RD, Spivak B, Yoran-Hegesh R, et al. Analysis of neurosteroid levels in attention deficit hyperactivity disorder. Int J Neuropsychopharmacol 2001; 4(3): 259-64.
[15]
Crino PB, Nathanson KL, Henske EP. The tuberous sclerosis complex. N Engl J Med 2006; 355(13): 1345-56.
[16]
Lo-Castro A, D’Agati E, Curatolo P. ADHD and genetic syndromes. Brain Dev 2011; 33(6): 456-61.
[17]
Torres Nupan MM, Velez Van Meerbeke A, López Cabra CA, et al. Cognitive and behavioral disorders in children with neurofibromatosis type 1. Front Pediatr 2017; 30(5): 227.
[18]
Kayl AE, Moore BD 3rd. Behavioral phenotype of neurofibromatosis, type 1. Ment Retard Dev Disabil Res Rev 2000; 6(2): 117-24.
[19]
Reilly C, Senior J, Murtagh L. ASD, ADHD, mental health conditions and psychopharmacology in neurogenetic syndromes: parent survey. J Intellect Disabil Res 2015; 59(4): 307-18.
[20]
Ji N, Findling RL. An update on pharmacotherapy for autism spectrum disorder in children and adolescents. Curr Opin Psychiatry 2015; 28(2): 91-101.
[21]
Gerlach LB, Kales HC. Managing behavioral and psychological symptoms of dementia. Psychiatr Clin North Am 2018; 41(1): 127-39.
[22]
Steinberg M, Hess K, Corcoran C, et al. Vascular risk factors and neuropsychiatric symptoms in Alzheimer’s disease: the Cache County Study. Int J Geriatr Psychiatry 2014; 29(2): 153-9.
[23]
Kales HC, Gitlin LN, Lyketsos CG. Assessment and management of behavioral and psychological symptoms of dementia. BMJ 2015; (2): 350-69.
[24]
Hebert LE, Scherr PA, Bienias JL, et al. Alzheimer’s disease in the US population: prevalence estimates using the 2000 census. Arch Neurol 2003; 60(8): 1119-22.
[25]
Dening T, Sandilyan MB. Dementia: definitions and types. Nurs Stand 2015; 29(37): 37-42.
[26]
Karantzoulis S, Galvin JE. Distinguishing Alzheimer’s disease from other major forms of dementia. Expert Rev Neurother 2011; 11(11): 1579-91.
[27]
Kar N. Behavioral and psychological symptoms of dementia and their management. Indian J Psychiatry 2009; 51(suppl 1): S77-86.
[28]
Scott KR, Barrett AM. Dementia syndromes: evaluation and treatment. Expert Rev Neurother 2007; 7(4): 407-22.
[29]
Staekenborg SS, Su T, van Straaten EC, et al. Behavioural and psychological symptoms in vascular dementia; differences between small-and large-vessel disease. J Neurol Neurosurg Psychiatry 2010; 81(5): 547-51.
[30]
Cerejeira J, Lagarto L, Mukaetova-Ladinska EB. Behavioral and psychological symptoms of dementia. Front Neurol 2012; 3: 73.
[31]
Neary D, Snowden J, Mann D. Frontotemporal dementia. Lancet Neurol 2005; 4(11): 771-80.
[32]
Liu W, Miller BL, Kramer JH, et al. Behavioral disorders in the frontal and temporal variants of fronto-temporal dementia. Neurology 2004; 62(5): 742-8.
[33]
Lozupone M, La Montagna M, D’Urso F, et al. Pharmacotherapy for the treatment of depression in patients with Alzheimer’s disease: a treatment-resistant depressive disorder. Expert Opin Pharmacother 2018; 19(8): 823-42.
[34]
Cummings J, Ballard C, Tariot P, et al. Potential treatment for dementia-related psychosis. J Prev Alzheimers Dis 2018; 5(4): 253-8.
[35]
Kales HC, Gitlin LN, Lyketsos CG. Management of the neuropsychiatric symptoms of dementia in clinical settings: recommendations from a multidisciplinary expert panel. J Am Geriatr Soc 2014; 62: 762-9.
[36]
Vlastelica M. Psychiatric aspects of basal ganglia diseases. Psychiatr Danub 2011; 23(2): 152-6.
[37]
Ring HA, Serra-Mestres J. Neuropsychiatry of the basal ganglia. J Neurol Neurosurg Psychiatry 2002; 72(1): 12-21.
[38]
Emre M. Dementia associated with Parkinson’s disease. Lancet Neurol 2003; 2(4): 229-37.
[39]
Grover S, Somaiya M, Kumar S, et al. Psychiatric aspects of Parkinson’s disease. J Neurosci Rural Pract 2015; 6(1): 65-76.
[40]
Lieberman A. Depression in Parkinson’s disease-a review. Acta Neurol Scand 2006; 113(1): 1-8.
[41]
Richard IH. Anxiety disorders in Parkinson’s disease. Adv Neurol 2005; 96: 42-55.
[42]
Schneider RB, Iourinets J, Richard IH. Parkinson’s disease psychosis: presentation, diagnosis and management. Neurodegener Dis Manag 2017; 7(6): 365-76.
[43]
Tröster AI, Fields JA, Koller WC. Parkinson’s disease and Parkinsonism. In: Coffey CE, Cummings JL, Eds. The American Psychiatric Press Textbook of Geriatric Neuropsychiatry. 2nd ed. Washington: American Psychiatric Press 2000; pp. 559-600.
[44]
Vajda FJ, Solinas C. Current approaches to management of depression in Parkinson’s disease. J Clin Neurosci 2005; 12(7): 739-43.
[45]
Friedman JH. Pharmacological interventions for psychosis in Parkinson’s disease patients. Expert Opin Pharmacother 2018; 19(5): 499-505.
[46]
Drobisz D, Damborská A. Deep brain stimulation targets for treating depression. Behav Brain Res 2019; 359: 266-73.
[47]
Ghosh R, Tabrizi SJ. Clinical Features of Huntington’s Disease. Adv Exp Med Biol 2018; 1049: 1-28.
[48]
McColgan P, Tabrizi SJ. Huntington’s disease: a clinical review. Eur J Neurol 2018; 25(1): 24-34.
[49]
Nopoulos PC. Huntington disease: a single-gene degenerative disorder of the striatum. Dialogues Clin Neurosci 2016; 18(1): 91-8.
[50]
Gövert F, Schneider SA. Huntington’s disease and Huntington’s disease-like syndromes: an overview. Curr Opin Neurol 2013; 26(4): 420-7.
[51]
Paulsen JS, Ready RE, Hamilton JM, et al. Neuropsychiatric aspects of Huntington’s disease. J Neurol Neurosurg Psychiatry 2001; 71(3): 310-4.
[52]
Paulsen JS, Nehl C, Hoth KF, et al. Depression and stages of Huntington’s disease. J Neuropsychiatry Clin Neurosci 2005; 17(4): 496-502.
[53]
Rosenblatt A, Leroi I. Neuropsychiatry of Huntington’s disease and other basal ganglia disorders. Psychosomatics 2000; 41(1): 24-30.
[54]
Van Duijn E, Kingma EM, van der Mast RC. Psychopathology in verified Huntington’s disease gene carriers. J Neuropsychiatry Clin Neurosci 2007; 19(4): 441-8.
[55]
Mestre TA, Ferreira JJ. An evidence-based approach in the treatment of Huntington’s disease. Parkinsonism Relat Disord 2012; 18(4): 316-20.
[56]
Coppen EM, Roos RA. Current Pharmacological Approaches to Reduce Chorea in Huntington’s Disease. Drugs 2017; 77(1): 29-46.
[57]
Robertson MM. A personal 35-year perspective on Gilles de la Tourette syndrome: prevalence, phenomenology, comorbidities, and coexistent psychopathologies. Lancet Psychiatry 2015; 2(1): 68-87.
[58]
Cummins G, Zandi M, Barker RA. Movement disorders and psychiatry: five new things. Neurol Clin Pract 2015; 5(2): 143-9.
[59]
Cavanna AE, Rickards H. The psychopathological spectrum of Gilles de la Tourette syndrome. Neurosci Biobehav Rev 2013; 37(6): 1008-15.
[60]
Egolf A, Coffey BJ. Current pharmacotherapeutic approaches for the treatment of Tourette syndrome. Drugs Today 2014; 50(2): 159-79.
[61]
Firneisz G, Lakatos PL, Szalay F, et al. Common mutations of ATP7B in Wilson disease patients from Hungary. Am J Med Genet 2002; 108(1): 23-8.
[62]
Scheiber IF, Brůha R, Dušek P. Pathogenesis of Wilson disease. Handb Clin Neurol 2017; 142: 43-55.
[63]
Zimbrean PC, Schilsky ML. Psychiatric aspects of Wilson disease: a review. Gen Hosp Psychiatry 2014; 36(1): 53-62.
[64]
Lauterbach EC. Fahr’Syndrome. In: Lauterbach EC, Ed. Psychiatric Management in Neurologic Disease. Washington: American Psychiatric Press 2000; pp. 137-78.
[65]
Lyketsos CG, Kozauer N, Rabins PV. Psychiatric manifestations of neurologic disease: where are we headed? Dialogues Clin Neurosci 2007; 9(2): 111-24.
[66]
Marcangelo MJ, Ovsiew F. Psychiatric aspects of epilepsy. Psychiatr Clin North Am 2007 Dec 30(4): 781-802.
[67]
Marsh L. Epilepsy. In: Lyketsos CG, Rabins PV, Lipsey JR, Slavney PR, Eds. Psychiatric Aspects of Neurologic Disease: Practical Approaches to Patient Care. New York: Oxford University Press 2008; pp. 159-87.
[68]
Torta R, Keller R. Behavioral, psychotic, and anxiety disorders in epilepsy: etiology, clinical features, and therapeutic implications. Epilepsia 1999; 40(Suppl. 10): S2-S20.
[69]
Marsh L, Rao V. Psychiatric complications in patients with epilepsy: a review. Epilepsy Res 2002; 49(1): 11-33.
[70]
Kanner AM. Depression in epilepsy: prevalence, clinical semiology, pathogenic mechanisms, and treatment. Biol Psychiatry 2003; 54(3): 388-98.
[71]
Sinanović O. Psychiatric disorders in neurology. Psychiatr Danub 2012; 24(Suppl. 3): S331-5.
[72]
Hesdorffer DC, Hauser WA, Olafsson E, et al. Depression and suicide attempt as risk factors for incident unprovoked seizures. Ann Neurol 2006; 59(1): 35-41.
[73]
Wiglusz MS, Cubała WJ, Gałuszko-Węgielnik M, et al. Mood disorders in epilepsy-diagnostic and methodological considerations. Psychiatr Danub 2012; 24(Suppl. 1): S44-50.
[74]
Meyrel M, Veyrier M, Nieto I, Bellivier F, Geoffroy PA. Two manic episodes related to a levetiracetam-based treatment in a 34-year-old female patient: A case report. J Clin Psychopharmacol 2019; 39(1): 87-8.
[75]
Clancy MJ, Clarke MC, Connor DJ, et al. The prevalence of psychosis in epilepsy; a systematic review and meta-analysis. BMC Psychiatry 2014; 13: 75.
[76]
Maguire M, Singh J, Marson A. Epilepsy and psychosis: a practical approach. Pract Neurol 2018; 18(2): 106-14.
[77]
Kanner AM, Rivas-Grajales AM. Psychosis of epilepsy: a multifaceted neuropsychiatric disorder. CNS Spectr 2016; 21(3): 247-57.
[78]
Akanuma N, Kanemoto K, Adachi N, et al. Prolonged postictal psychosis with forced normalization (Landolt) in temporal lobe epilepsy. Epilepsy Behav 2005; 6(3): 456-9.
[79]
Russ SA, Larson K, Halfon N. A national profile of childhood epilepsy and seizure disorder. Pediatrics 2012; 129(2): 256-64.
[80]
Hesdorffer DC, Ludvigsson P, Olafsson E, et al. ADHD as a risk factor for incident unprovoked seizures and epilepsy in children. Arch Gen Psychiatry 2004; 61(7): 731-6.
[81]
Becker K, Holtmann M. Role of electroencephalography in attention-deficit hyperactivity disorder. Expert Rev Neurother 2006; 6(5): 731-9.
[82]
Sánchez-Carpintero R, Neville BG. Attentional ability in children with epilepsy. Epilepsia 2003; 44(10): 1340-9.
[83]
Gucuyener K, Erdemoglu AK, Senol S, et al. Use of methylphenidate for attention-deficit hyperactivity disorder in patients with epilepsy or electroencephalographic abnormalities. J Child Neurol 2003; 18(2): 109-12.
[84]
Strasser L, Downes M, Kung J, et al. Prevalence and risk factors for autism spectrum disorder in epilepsy: a systematic review and meta-analysis. Dev Med Child Neurol 2018; 60(1): 19-29.
[85]
Besag FM. Epilepsy in patients with autism: links, risks and treatment challenges. Neuropsychiatr Dis Treat 2017; 14: 1-10.
[86]
Salpekar JA, Mula M. Common psychiatric comorbidities in epilepsy: How big of a problem is it? Epilepsy Behav 2018. [Epub ahead of print].
[87]
Trauner DA. Behavioral correlates of epileptiform abnormalities in autism. Epilepsy Behav 2015; 47: 163-6.
[88]
Robinson RG, Jorge RE. Post-stroke depression: a review. Am J Psychiatry 2016; 173(3): 221-31.
[89]
Cummings JL, Arciniegas DB, Brooks BR, et al. Defining and diagnosing involuntary emotional expression disorder. CNS Spectr 2006; (S6): 1-7.
[90]
Ayerbe L, Ayis S, Wolfe CD, et al. Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry 2013; 202(1): 14-21.
[91]
Narushima K, Kosier JT, Robinson RG. A reappraisal of post-stroke depression, intra-and inter-hemispheric lesion location using meta-analysis. J Neuropsychiatry Clin Neurosci 2003; 15(4): 422-30.
[92]
Chemerinski E, Levine SR. Neuropsychiatric disorders following vascular brain injury. Mt Sinai J Med 2006; 73(7): 1006-14.
[93]
Fruehwald S, Gatterbauer E, Rehak P, et al. Early fluoxetine treatment of post-stroke depression-a three-month double-blind placebo-controlled study with an open-label long-term follow up. J Neurol 2003; 250(3): 347-51.
[94]
Jin HJ, Pei L, Li YN, et al. Alleviative effects of fluoxetine on depressive-like behaviors by epigenetic regulation of BDNF gene transcription in mouse model of post-stroke depression. Sci Rep 2017; 7(1): 14926.
[95]
Caeiro L, Ferro JM, Figueira ML. Apathy in acute stroke patients. Eur J Neurol 2012; 19(2): 291-7.
[96]
Yang SR, Shang XY, Tao J, et al. Voxel-based analysis of fractional anisotropy in post-stroke apathy. PLoS One 2015; 10(1): e116-68.
[97]
Ferro JM, Caeiro L, Figueira ML. Neuropsychiatric sequelae of stroke. Nat Rev Neurol 2016; 12(5): 269-80.
[98]
Campbell Burton CA, Murray J, Holmes J, et al. Frequency of anxiety after stroke: a systematic review and meta-analysis of observational studies. Int J Stroke 2013; 8(7): 545-59.
[99]
Castillo CS, Schultz SK, Robinson RG. Clinical correlates of early-onset and late-onset post-stroke generalized anxiety. Am J Psychiatry 1995; 152(8): 1174-9.
[100]
Chemerinski E, Robinson RG. The neuropsychiatry of stroke. Psychosomatics 2000; 41(1): 5-14.
[101]
Ferro JM, Caeiro L, Santos C. Post-stroke emotional and behavior impairment: a narrative review. Cerebrovasc Dis 2009; 27(Suppl. 1): 197-203.
[102]
Satzer D, Bond DJ. Mania secondary to focal brain lesions: implications for understanding the functional neuroanatomy of bipolar disorder. Bipolar Disord 2016; 18(3): 205-20.
[103]
Stangeland H, Orgeta V, Bell V. Post-stroke psychosis: a systematic review. J Neurol Neurosurg Psychiatry 2018; 89(8): 879-85.
[104]
Kaplin A, Carrol K. Multiple Sclerosis. In: Lyketsos CG, Rabins PV, Lipsey JR, Slavney PR, Eds. Psychiatric Aspects of Neurologic Disease: Practical Approaches to Patient Care. New York: NY Oxford University Press 2008; pp. 131-57.
[105]
Ahmed S, Venigalla H, Mekala HM, et al. Traumatic brain injury and neuropsychiatric complications. Indian J Psychol Med 2017; 39(2): 114-21.
[106]
Rao V, Lyketsos C. Neuropsychiatric sequelae of traumatic brain injury. Psychosomatics 2000; 41(2): 95-103.
[107]
Lee HB, Lyketsos CG, Rao V. Pharmacological management of the psychiatric aspects of traumatic brain injury. Int Rev Psychiatry 2003; 15(4): 359-70.
[108]
Fujii D, Ahmed I. Characteristics of psychotic disorder due to traumatic brain injury: an analysis of case studies in the literature. J Neuropsychiatry Clin Neurosci 2002; 14(2): 130-40.
[109]
Kim E, Lauterbach EC, Reeve A, et al. Neuropsychiatric complications of traumatic brain injury: a critical review of the literature (a report by the ANPA Committee on Research). J Neuropsychiatry Clin Neurosci 2007; 19(2): 106-27.
[110]
Gil S, Caspi Y, Ben-Ari IZ, et al. Does memory of a traumatic event increase the risk for posttraumatic stress disorder in patients with traumatic brain injury? A prospective study. Am J Psychiatry 2005; 162(5): 963-9.
[111]
Karussis D. The diagnosis of multiple sclerosis and the various related demyelinating syndromes: a critical review. J Autoimmun 2014; 48(49): 134-42.
[112]
Murphy R, O’Donoghue S, Counihan T, et al. Neuropsychiatric syndromes of multiple sclerosis. J Neurol Neurosurg Psychiatry 2017; 88(8): 697-708.
[113]
Feinstein A. The neuropsychiatry of multiple sclerosis. Can J Psychiatry 2004; 49(3): 157-63.
[114]
Ghaffar O, Feinstein A. The neuropsychiatry of multiple sclerosis: a review of recent developments. Curr Opin Psychiatry 2007; 20(3): 278-85.
[115]
Lynch SG, Kroencke DC, Denney DR. The relationship between disability and depression in multiple sclerosis: the role of uncertainty, coping, and hope. Mult Scler 2001; 7(6): 411-6.
[116]
Sijens PE, Mostert JP, Irwan R, et al. Impact of fluoxetine on the human brain in multiple sclerosis as quantified by proton magnetic resonance spectroscopy and diffusion tensor imaging. Psychiatry Res 2008; 164(3): 274-82.
[117]
Madhusoodanan S, Ting MB, Farah T, et al. Psychiatric aspects of brain tumors: A review. World J Psychiatry 2015; 5(3): 273-85.
[118]
Price TR, Goetz KL, Lovell MR. Neuropsychiatric Aspects of Brain Tumors. In: Yudofsky SC, Hales RE, Eds. The American Psychiatric Publishing Textbook of Neuropsychiatry and Behavioral Neurosciences. 5th ed. Arlington: American Psychiatric Publishing 2007; pp. 735-64.
[119]
Madhusoodanan S, Danan D, Moise D. Psychiatric manifestations of brain tumors: diagnostic implications. Expert Rev Neurother 2007; 7(4): 343-9.
[120]
Rooney AG, Carson A, Grant R. Depression in cerebral glioma patients: a systematic review of observational studies. J Natl Cancer Inst 2011; 103(1): 61-76.
[121]
Filley CM, Kleinschmidt-DeMasters BK. Neurobehavioral presentations of brain neoplasms. West J Med 1995; 163(1): 19-25.
[122]
Weitzner MA, Kanfer S, Booth-Jones M. Apathy and pituitary disease: it has nothing to do with depression. J Neuropsychiatry Clin Neurosci 2005; 17(2): 159-66.
[123]
Marin RS. Apathy: Concept, Syndrome, Neural Mechanisms, and Treatment. Semin Clin Neuropsychiatry 1996; 1(4): 304-14.
[124]
Madhusoodanan S, Opler MG, Moise D, et al. Brain tumor location and psychiatric symptoms: is there any association? A meta-analysis of published case studies. Expert Rev Neurother 2010; 10(10): 1529-36.
[125]
Dalmau J, Bataller L. Limbic encephalitis: the new cell membrane antigens and a proposal of clinical-immunological classification with therapeutic implications. Neurologia 2007; 22(8): 526-37.
[126]
Warren N, Siskind D, O’Gorman C. Refining the psychiatric syndrome of anti-N-methyl-d-aspartate receptor encephalitis. Acta Psychiatr Scand 2018; 138(5): 401-8.
[127]
Kayser MS, Dalmau J. Anti-NMDA receptor encephalitis in psychiatry. Curr Psychiatry Rev 2011; 7(3): 189-93.
[128]
Kuppuswamy PS, Takala CR, Sola CL. Management of psychiatric symptoms in anti-NMDAR encephalitis: a case series, literature review and future directions. Gen Hosp Psychiatry 2014; 36(4): 388-91.
[129]
Gibson LL, Pollak TA, Blackman G, et al. The psychiatric phenotype of anti-nmda receptor encephalitis. J Neuropsychiatry Clin Neurosci 2018; 31(1): 70-9.
[130]
Barry H, Byrne S, Barrett E, et al. Anti-N-methyl-d-aspartate receptor encephalitis: review of clinical presentation, diagnosis and treatment. BJPsych Bull 2015; 39(1): 19-23.
[131]
Callari A, Bartolommei N, Lattanzi L, et al. Clinical management of catatonic syndromes. Part I: diagnosis, clinical setting and treatment principles. J Psychopathology 2014; 20: 144-52.


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 15
ISSUE: 2
Year: 2019
Page: [132 - 142]
Pages: 11
DOI: 10.2174/1573400515666190411142109

Article Metrics

PDF: 15
HTML: 2
EPUB: 1
PRC: 1