The majority of patients with anti-N-methyl-D-aspartate-receptor encephalitis (NMDAE) present a characteristic movement disorder, which consists of complex bilateral stereotyped movements of the arms, with perioral and eye movements, and less frequently involvement of the legs. We have observed striking similarities in the characteristics of the abnormal movements observed in NMDAE and those described in Status Dissociatus, which is characterized by a complete breakdown of state-determining boundaries (wakefulness, REM and NREM sleep) and can result from pathophysiologically diverse disorders (e.g. fatal familial insomnia, delirium tremens, Morvan's syndrome). Here, we suggest that the state of paradoxical responsiveness in which NMDAE patients present these stereotyped movements may be that of Status Dissociatus and discuss the clinical similarities and pathophysiological explanations that support such a suggestion. This hypothesis explains why patients that seem to be unconscious have a movement disorder that is not epileptic and may have management implications, since many patients with NMDAE-related movement disorder are treated with anticonvulsants that may not be indicated.

The distinct movement disorder in anti-N-methyl-D-aspartate-receptor encephalitis may be related to status dissociatus: A hypothesis / Stamelou, M.; Plazzi, G.; Lugaresi, E.; Edwards, M. J.; Bhatia, K. P.. - In: MOVEMENT DISORDERS. - ISSN 0885-3185. - 27:11(2012), pp. 1360-1363. [10.1002/mds.25072]

The distinct movement disorder in anti-N-methyl-D-aspartate-receptor encephalitis may be related to status dissociatus: A hypothesis

Plazzi G.;
2012

Abstract

The majority of patients with anti-N-methyl-D-aspartate-receptor encephalitis (NMDAE) present a characteristic movement disorder, which consists of complex bilateral stereotyped movements of the arms, with perioral and eye movements, and less frequently involvement of the legs. We have observed striking similarities in the characteristics of the abnormal movements observed in NMDAE and those described in Status Dissociatus, which is characterized by a complete breakdown of state-determining boundaries (wakefulness, REM and NREM sleep) and can result from pathophysiologically diverse disorders (e.g. fatal familial insomnia, delirium tremens, Morvan's syndrome). Here, we suggest that the state of paradoxical responsiveness in which NMDAE patients present these stereotyped movements may be that of Status Dissociatus and discuss the clinical similarities and pathophysiological explanations that support such a suggestion. This hypothesis explains why patients that seem to be unconscious have a movement disorder that is not epileptic and may have management implications, since many patients with NMDAE-related movement disorder are treated with anticonvulsants that may not be indicated.
2012
27
11
1360
1363
The distinct movement disorder in anti-N-methyl-D-aspartate-receptor encephalitis may be related to status dissociatus: A hypothesis / Stamelou, M.; Plazzi, G.; Lugaresi, E.; Edwards, M. J.; Bhatia, K. P.. - In: MOVEMENT DISORDERS. - ISSN 0885-3185. - 27:11(2012), pp. 1360-1363. [10.1002/mds.25072]
Stamelou, M.; Plazzi, G.; Lugaresi, E.; Edwards, M. J.; Bhatia, K. P.
File in questo prodotto:
Non ci sono file associati a questo prodotto.
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1206080
Citazioni
  • ???jsp.display-item.citation.pmc??? 7
  • Scopus 43
  • ???jsp.display-item.citation.isi??? 35
social impact