Quand les psychiatres ne concluent pas à un diagnostic psychiatrique : à propos d’un cas d’encéphalite auto-immune

Abstract

Anti-NMDA receptor encephalitis (also called anti-NMDAr encephalitis) has been described since 2007 and most often manifests itself through psychiatric and cognitive disorders and dysautonomia. This diagnosis is still little known among practitioners. In rare cases, this pathology has a solely psychiatric presentation. We propose here to address the situation of a 26-year-old young woman who presented with a psychotic-like decompensation, with some atypical points, leading to a form of diagnostic wandering for almost a year before the hypothesis of ANTI-NMDAr encephalitis was validated and appropriate therapy was initiated. In this article, we describe the care pathway of this patient, the clinical hypotheses and the multidisciplinary consultations that led to this diagnosis.