Neurological exam maneuver tricks:
- if patient with poor attention, can test coordination by tickling the nose and can test visual fields by checking for blink to threat
- important to make a distinction between sleepy and inattentive, which distinguishes alterations in consciousness from an inability to attend
Posted 09/26/16 11:10:59 AM by Anna Krigel
Anti-NMDA-receptor encephalitis presentation:
- may present or begin with a prodromal headache, fever, or viral-like syndrome
- prominent psychiatric manifestations - anxiety, agitation, bizarre behavior
- memory deficits
- seizures, decreased levels of consciousness
- motor dysfunction, dyskinesias
- MRI normal in 70% of cases, can see non-specific hyperintensities
- often associated with ovarian teratomas in women
Posted 09/26/16 11:34:11 AM by Anna Krigel
Treatment algorithm for anti-NMDA-receptor encephalitis
- Evaluate for ovarian tumor
- Tumor removal if tumor present
- If no response or if no tumor presents, proceed to immunomodulators
- Start with methylprednisolone plus IVIG or plasma exchange
- If no or minimal response, treat with rituximab or cyclophosphamide
Posted 09/26/16 11:39:31 AM by Anna Krigel
For further reading...
Posted 09/26/16 11:40:35 AM by Anna Krigel
Created by Christopher Kelly
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