Anti-NMDA-receptor encephalitis: case report and literature review of an under-recognized condition.


:Anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis is an immune-mediated syndrome that remains under-recognized despite a growing body of literature. This syndrome has been predominantly described in young females with a constellation of symptoms, including personality changes, autonomic dysfunction and neurologic decompensation. It is commonly associated with mature ovarian teratomas. We describe the classic presentation of anti-NMDA-R encephalitis in three dramatically different patients: Case A, a young woman with ovarian teratoma; Case B, the eldest case reported to date; and Case C, a young male with no identifiable tumor. We review the literature summarizing the differential diagnosis, investigative approach, treatment options and challenges inherent to this disorder. We advocate good supportive care, involvement of multiple health disciplines and use of immune-modulating therapies in patient management. These cases underscore the need for increased awareness and high diagnostic suspicion when approaching the patient with suspected viral encephalitis.


J Gen Intern Med


Day GS,High SM,Cot B,Tang-Wai DF




Has Abstract


2011-07-01 00:00:00












  • Predictors of early hospital readmission in HIV-infected patients with pneumonia.

    abstract:OBJECTIVE:Although hospitalization patterns have been studied, little is known about hospital readmission among HIV-infected patients in the era of highly active antiretroviral therapy. We explored the risk factors for early readmission to a tertiary care inner-city hospital among HIV-infected patients with pneumonia i...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Palepu A,Sun H,Kuyper L,Schechter MT,O'Shaughnessy MV,Anis AH

    更新日期:2003-04-01 00:00:00

  • Peer Support for Self-Management of Chronic Pain: the Evaluation of a Peer Coach-Led Intervention to Improve Pain Symptoms (ECLIPSE) Trial.

    abstract:BACKGROUND:Pain self-management is an effective, evidence-based treatment for chronic pain. Peer support, in which patients serve as coaches for other patients, has been effective in other chronic conditions and is a potentially promising approach to implementing pain self-management programs using fewer clinical resou...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Matthias MS,Bair MJ,Ofner S,Heisler M,Kukla M,McGuire AB,Adams J,Kempf C,Pierce E,Menen T,McCalley S,Johnson NL,Daggy J

    更新日期:2020-12-01 00:00:00

  • Coronary Artery Disease and Atherosclerotic Risk Factors in a Population-Based Study of Sudden Death.

    abstract:BACKGROUND:Sudden death is a public health problem with major impact on society. Coronary artery disease (CAD) is believed to underlie 60-80% of these deaths. While deaths from CAD have decreased in the recent decades, sudden death rates remain unacceptably high. OBJECTIVE:We aimed to assess the prevalence of CAD and ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Joodi G,Maradey JA,Bogle B,Mirzaei M,Sadaf MI,Pursell I,Henderson C,Mounsey JP,Simpson RJ Jr

    更新日期:2020-02-01 00:00:00

  • Chronic illness with complexity: implications for performance measurement of optimal glycemic control.

    abstract:OBJECTIVE:To evaluate the association between chronic illness with complexity (CIC) and optimal glycemic control. PARTICIPANTS:Cross-sectional and longitudinal analyses of Diabetes Epidemiologic Cohort database of Veterans Health Administration (VHA) users with diabetes, less than 75 years old, with HbA1c tests in fis...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Meduru P,Helmer D,Rajan M,Tseng CL,Pogach L,Sambamoorthi U

    更新日期:2007-12-01 00:00:00

  • Comparing care for breast cancer survivors to non-cancer controls: a five-year longitudinal study.

    abstract:BACKGROUND:Deficiencies in care for cancer survivors may result from unclear roles for primary care providers (PCPs) and oncology specialists in follow-up. OBJECTIVES:To compare cancer survivors' care to non-cancer controls. DESIGN:Retrospective, longitudinal, controlled study starting 366 days post-diagnosis. SUBJE...

    journal_title:Journal of general internal medicine

    pub_type: 临床试验,杂志文章


    authors: Snyder CF,Frick KD,Peairs KS,Kantsiper ME,Herbert RJ,Blackford AL,Wolff AC,Earle CC

    更新日期:2009-04-01 00:00:00

  • Factors influencing the selection of general internal medicine fellowship programs: a national survey.

    abstract::Although criteria are available to guide the selection of general internal medicine (GIM) fellowship programs, the factors actually used in this process are unclear. Using a survey of current GIM fellows, we determined that most received information from their residency advisors, and many viewed them as the most impor...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Caiola E,Litaker D

    更新日期:2000-09-01 00:00:00

  • Teaching Medical Students to Help Patients Quit Smoking: Outcomes of a 10-School Randomized Controlled Trial.

    abstract:BACKGROUND:Early in medical education, physicians must develop competencies needed for tobacco dependence treatment. OBJECTIVE:To assess the effect of a multi-modal tobacco dependence treatment curriculum on medical students' counseling skills. DESIGN:A group-randomized controlled trial (2010-2014) included ten U.S. ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Ockene JK,Hayes RB,Churchill LC,Crawford SL,Jolicoeur DG,Murray DM,Shoben AB,David SP,Ferguson KJ,Huggett KN,Adams M,Okuliar CA,Gross RL,Bass PF 3rd,Greenberg RB,Leone FT,Okuyemi KS,Rudy DW,Waugh JB,Geller AC

    更新日期:2016-02-01 00:00:00

  • Plumbism or lead intoxication mimicking an abdominal tumor.

    abstract::The clinical presentation of lead intoxication may vary widely and in the absence of a high clinical index of suspicion, the diagnosis may be missed. The effects of lead on mitochondrial oxidative phosphorylation and its interaction with calcium-mediated processes explain the heterogenous presentation. In this case re...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Dedeken P,Louw V,Vandooren AK,Verstegen G,Goossens W,Dubois B

    更新日期:2006-06-01 00:00:00

  • Use of Simulated Patient Encounters to Teach Residents to Respond to Patients Who Discriminate Against Health Care Workers.

    abstract:BACKGROUND:Previous studies indicate that medical trainees frequently experience discrimination by patients. Little is known about effective strategies to teach trainees to respond to this discrimination. AIM:To create a workshop for first-year residents utilizing standardized patients to improve skills in responding ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Eisenberg EH,Kieffer KA

    更新日期:2019-05-01 00:00:00

  • Implementation of local guidelines for cost-effective management of hypertension. A trial of the firm system.

    abstract:OBJECTIVE:To evaluate the effects of an intensive intervention to implement guidelines for cost-effective management of hypertension on medication use and cost, blood pressure control, and other resource use. DESIGN:Retrospective cohort trial based on the Cleveland Veterans' Affairs Medical Center Firm System. SETTIN...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Aucott JN,Pelecanos E,Dombrowski R,Fuehrer SM,Laich J,Aron DC

    更新日期:1996-03-01 00:00:00

  • Using the Knowledge Base of Health Services Research to Redefine Health Care Systems.

    abstract::This Perspective discusses 12 key facts derived from 50 years of health services research and argues that this knowledge base can stimulate innovative thinking about how to make health care systems safer, more efficient, more cost effective, and more patient centered, even as they respond to the needs of diverse commu...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,评审


    authors: Brook RH,Vaiana ME

    更新日期:2015-10-01 00:00:00

  • Cultural sensitivity in screening adults for a history of childhood abuse: evidence from a community sample.

    abstract:BACKGROUND:A number of practice guidelines and recommendations call for the assessment of childhood abuse history among adult medical patients. The cultural sensitivity of screening questions, however, has not been examined. OBJECTIVE:To assess whether questions that inquire about childhood abuse history function diff...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Thombs BD,Bennett W,Ziegelstein RC,Bernstein DP,Scher CD,Forde DR

    更新日期:2007-03-01 00:00:00

  • Usability of FDA-approved medication guides.

    abstract:BACKGROUND:Medication guides are required documents to be distributed to patients in order to convey serious risks associated with certain prescribed medicines. Little is known about the effectiveness of this information to adequately inform patients on safe use. OBJECTIVE:To examine the readability, suitability, and ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Wolf MS,King J,Wilson EA,Curtis LM,Bailey SC,Duhig J,Russell A,Bergeron A,Daly A,Parker RM,Davis TC,Shrank WH,Lambert B

    更新日期:2012-12-01 00:00:00

  • Weight loss success in metabolic syndrome by telephone interventions: results from the SHINE Study.

    abstract:BACKGROUND:The Diabetes Prevention Program (DPP) intensive lifestyle intervention resulted in significant weight loss, reducing the development of diabetes, but needs to be adapted to primary care provider (PCP) practices. OBJECTIVES:To compare a DPP-translation using individual (IC) vs. conference (CC) calls delivere...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Weinstock RS,Trief PM,Cibula D,Morin PC,Delahanty LM

    更新日期:2013-12-01 00:00:00

  • Efficacy of a one-month training block in psychosocial medicine for residents: a controlled study.

    abstract:STUDY OBJECTIVE:To determine the efficacy of a comprehensive, one-month psychosocial training program for first-year medical residents. DESIGN:Nonrandomized, controlled study with immediate pre/post evaluation. Limited evaluation of some residents was also conducted an average of 15 months after teaching. SETTING:Com...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Smith RC,Osborn G,Hoppe RB,Lyles JS,Van Egeren L,Henry R,Sego D,Alguire P,Stoffelmayr B

    更新日期:1991-11-01 00:00:00

  • Prospective study of new participants in a community-based mind-body training program.

    abstract:BACKGROUND:Mind-body practices such as yoga are widely popular, but little is known about how such exercises impact health-related quality of life. OBJECTIVE:To measure changes in health-related quality of life associated with 3 months of mind-body training as practiced in community-based settings. DESIGN:Prospective...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Lee SW,Mancuso CA,Charlson ME

    更新日期:2004-07-01 00:00:00

  • "Serious and complex illness" in quality improvement and policy reform for end-of-life care.

    abstract::Americans are living longer - a mark of success in public health and medical care - but more will live the last few years with progressive illness and disability. The dominant conception of care delivery separates "aggressive" or life-extending care from "palliative" or death-accepting care, with an assumed "transitio...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Lynn J,Forlini JH

    更新日期:2001-05-01 00:00:00

  • Mixed-methods evaluation of a telehealth collaborative care program for persons with HIV infection in a rural setting.

    abstract:BACKGROUND:Delivery of comprehensive care for persons with human immunodeficiency virus (HIV) infection in rural and low prevalence settings presents many challenges. We developed and evaluated a telehealth collaborative care (TCC) program for persons with HIV in a rural area. OBJECTIVE:To determine the feasibility of...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Ohl M,Dillon D,Moeckli J,Ono S,Waterbury N,Sissel J,Yin J,Neil B,Wakefield B,Kaboli P

    更新日期:2013-09-01 00:00:00

  • Surgery for herniated lumbar discs: a literature synthesis.

    abstract:OBJECTIVE:To assess the risks and benefits of surgery for herniated lumbar discs (discectomy) and to evaluate the methodologic quality of the literature. DESIGN:Literature synthesis. STUDY SELECTION AND DATA ANALYSIS: A structured MEDLINE search identified studies of standard, microsurgical, or percutaneous discectomy...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,meta分析


    authors: Hoffman RM,Wheeler KJ,Deyo RA

    更新日期:1993-09-01 00:00:00

  • "Mini-Residency" in Musculoskeletal Care: a National Continuing Professional Development Program for Primary Care Providers.

    abstract:INTRODUCTION:A cost-effective professional development program enhancing musculoskeletal (MSK) skills of physicians and allied health providers working in primary care settings has been reported at a single site. This article describes the first 2 years of the national expansion and implementation of a 3-day "MSK Mini-...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Battistone MJ,Barker AM,Grotzke MP,Beck JP,Lawrence P,Cannon GW

    更新日期:2016-11-01 00:00:00

  • Measuring resident well-being: impostorism and burnout syndrome in residency.

    abstract:BACKGROUND:Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the t...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Legassie J,Zibrowski EM,Goldszmidt MA

    更新日期:2008-07-01 00:00:00

  • The long-term health outcomes of childhood abuse. An overview and a call to action.

    abstract::While the association between abuse in childhood and adverse adult health outcomes is well established, this link is infrequently acknowledged in the general medical literature. This paper has 2 purposes: (1) to provide a broad overview of the research on the long-term effects of child abuse on mental and physical hea...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,评审


    authors: Springer KW,Sheridan J,Kuo D,Carnes M

    更新日期:2003-10-01 00:00:00

  • Impact of an Overnight Internal Medicine Academic Hospitalist Program on Patient Outcomes.

    abstract:BACKGROUND:Many academic hospitals have implemented overnight hospitalists to supervise house staff and improve outcomes, but few studies have described the impact of this role. OBJECTIVE:To investigate the effect of an overnight academic hospitalist program on patient-level outcomes. Secondary objectives were to desc...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Gonzalo JD,Kuperman EF,Chuang CH,Lehman E,Glasser F,Abendroth T

    更新日期:2015-12-01 00:00:00

  • Impact of echocardiography on the management of patients with mitral valve prolapse.

    abstract:OBJECTIVE:To determine whether echocardiography affects the decisions to use beta blockers or to recommend bacterial endocarditis prophylaxis in patients suspected of having mitral valve prolapse (MVP). DESIGN:Retrospective review of echocardiograms and clinical records. SETTING:Military tertiary care hospital. PATI...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Olive KE,Grassman ED

    更新日期:1990-11-01 00:00:00

  • Are opioid dependence and methadone maintenance treatment (MMT) documented in the medical record? A patient safety issue.

    abstract:BACKGROUND:Opioid-dependent patients often have co-occurring chronic illnesses requiring medications that interact with methadone. Methadone maintenance treatment (MMT) is typically provided separately from medical care. Hence, coordination of medical care and substance use treatment is important to preserve patient sa...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Walley AY,Farrar D,Cheng DM,Alford DP,Samet JH

    更新日期:2009-09-01 00:00:00

  • What is most important to patients when deciding about colorectal screening?

    abstract:BACKGROUND:Colorectal cancer (CRC) screening can be administered through tests with varied characteristics and is a preference-sensitive decision. OBJECTIVE:To assess patient experiences with a Maximum Differences Scaling (MDS) tool for eliciting values about CRC screening test characteristics and determine whether pa...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Imaeda A,Bender D,Fraenkel L

    更新日期:2010-07-01 00:00:00

  • Use of complementary and alternative medicine and self-rated health status: results from a national survey.

    abstract:BACKGROUND:Despite the absence of conclusive evidence of effectiveness, complementary and alternative medicine (CAM) is used by 4 of 10 adults in the US; little is known about the association between CAM use and health status. OBJECTIVE:To determine the relation between CAM use and self-reported health status and heal...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Nguyen LT,Davis RB,Kaptchuk TJ,Phillips RS

    更新日期:2011-04-01 00:00:00

  • A transitional opioid program to engage hospitalized drug users.

    abstract:BACKGROUND:Many opioid-dependent patients do not receive care for addiction issues when hospitalized for other medical problems. Based on 3 years of clinical practice, we report the Transitional Opioid Program (TOP) experience using hospitalization as a "reachable moment" to identify and link opioid-dependent persons t...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Shanahan CW,Beers D,Alford DP,Brigandi E,Samet JH

    更新日期:2010-08-01 00:00:00

  • Patterns of responses on health-related quality of life questionnaires among patients with HIV/AIDS.

    abstract:BACKGROUND:Health-related quality of life (HRQoL) has become an important facet of HIV/AIDS research. Typically, the unit of analysis is either the total instrument score or subscale score. Developing a typology of responses across various HRQoL measures, however, may advance understating of patients' perspectives. ME...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Kudel I,Farber SL,Mrus JM,Leonard AC,Sherman SN,Tsevat J

    更新日期:2006-12-01 00:00:00

  • Mental status changes and stroke.

    abstract:OBJECTIVE:To determine the frequency with which an acute confusional state is caused by a stroke and to evaluate the usefulness of obtaining computed tomography scans in this setting. DESIGN:Retrospective analysis. SETTING:Tertiary referral center. PATIENTS:The authors reviewed 127 neurology consultations requested ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章


    authors: Benbadis SR,Sila CA,Cristea RL

    更新日期:1994-09-01 00:00:00