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  1. Book ; Online: Recent Advances in Psychiatry from Psycho-Neuro-Immunology Research: Autoimmunencephalitis, Autoimmune-Encephalopathy, Mild Encephalitis

    Bechter, Karl / Brown, David / Najjar, Souhel

    2019  

    Keywords Medicine ; Psychiatry ; Severe mental disorders ; autoimmune encephalitis ; autoimmune psychosis ; Mild encephalitis ; psychosis ; Neuroinflammation ; Schizophrenia ; Depression ; Affective psychosis ; autoimme
    Size 1 electronic resource (189 pages)
    Publisher Frontiers Media SA
    Document type Book ; Online
    Note English ; Open Access
    HBZ-ID HT021231486
    ISBN 9782889459506 ; 2889459500
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Article: Autoimmune Encephalitis: A Physician's Guide to the Clinical Spectrum Diagnosis and Management.

    Patel, Arpan / Meng, Yue / Najjar, Amanda / Lado, Fred / Najjar, Souhel

    Brain sciences

    2022  Volume 12, Issue 9

    Abstract: The rapidly expanding spectrum of autoimmune encephalitis in the last fifteen years is largely due to ongoing discovery of many neuronal autoantibodies. The diagnosis of autoimmune encephalitis can be challenging due to the wide spectrum of clinical ... ...

    Abstract The rapidly expanding spectrum of autoimmune encephalitis in the last fifteen years is largely due to ongoing discovery of many neuronal autoantibodies. The diagnosis of autoimmune encephalitis can be challenging due to the wide spectrum of clinical presentations, prevalence of psychiatric features that mimic primary psychiatric illnesses, frequent absence of diagnostic abnormalities on conventional brain MR-imaging, non-specific findings on EEG testing, and the lack of identified IgG class neuronal autoantibodies in blood or CSF in a subgroup of patients. Early recognition and treatment are paramount to improve outcomes and achieve complete recovery from these debilitating, occasionally life threatening, disorders. This review is aimed to provide primary care physicians and hospitalists who, together with neurologist and psychiatrists, are often the first port of call for individuals presenting with new-onset neuropsychiatric symptoms, with up-to-date data and evidence-based approach to the diagnosis and management of individuals with neuropsychiatric disorders of suspected autoimmune origin.
    Language English
    Publishing date 2022-08-25
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2651993-8
    ISSN 2076-3425
    ISSN 2076-3425
    DOI 10.3390/brainsci12091130
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Case Report: HSV-2 Encephalitis Presenting With Chorea; Effects of Infection Alone or Combination of Infection and Autoimmunity?

    Kolesnik, Michael / Ballout, Ahmad A / Hameed, Natasha / Najjar, Souhel

    Frontiers in neurology

    2021  Volume 12, Page(s) 790514

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2021-12-10
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2021.790514
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Neuromyelitis Optica Spectrum Disorder Mimicking Pontine Stroke: A Case Report and Systematic Literature Review.

    Huang, Brendan / Arora, Rohan / McFarlane, Spencer / Diamond, Joseph A / Najjar, Souhel

    Cureus

    2023  Volume 15, Issue 6, Page(s) e41099

    Abstract: Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disorder that was first described in the late 1800s as a variant of multiple sclerosis (MS). However, it has recently been categorized, as a disease, especially with the discovery of ... ...

    Abstract Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disorder that was first described in the late 1800s as a variant of multiple sclerosis (MS). However, it has recently been categorized, as a disease, especially with the discovery of aquaporin-4 (AQP4-Ab) and myelin oligodendrocyte glycoprotein antibodies (MOG-Ab). Unfortunately, patient presentation is not always clear, and NMOSD may initially be diagnosed as an alternative neurological disease. We present a 58-year-old woman who was hospitalized several times for what was initially perceived as a pontine stroke. However, given worsening symptoms, serologic testing confirmed AQP4-Ab positivity and, subsequently, the NMOSD diagnosis. In addition to the case report, a systematic literature review was performed to identify NMOSD cases initially misdiagnosed as stroke. Publications were selected and curated in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six NMOSD patients were initially thought to have had acute strokes. However, steady progression and/or the recurrence of symptoms suggested that further investigations with neuroimaging studies and serological immune assays were necessary to exclude alternative etiologies. Notably, the age at onset in all cases was significantly more advanced than patients with typical NMOSD presentations (median age 32-41). In conclusion, the NMOSD diagnosis should be considered in cases with atypical stroke-like presentations, particularly those of later onset (defined as equal to or greater than 50 years of age). This is important as early recognition and treatment with immune therapies can improve functional outcomes.
    Language English
    Publishing date 2023-06-28
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.41099
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Reader Response: Clinical, Neuroimmunologic, and CSF Investigations in First Episode Psychosis.

    Pollak, Thomas A / Prüss, Harald / Bechter, Karl / Najjar, Souhel / Vincent, Angela

    Neurology

    2021  Volume 97, Issue 21, Page(s) 1009–1010

    MeSH term(s) Humans ; Neuroimmunomodulation ; Psychotic Disorders/diagnosis
    Language English
    Publishing date 2021-11-22
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0000000000012898
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  6. Article: Case report: Bilateral globus pallidus lesions and delayed progressive leukoencephalopathy in COVID-19: Effects of hypoxia alone or combination of hypoxia and inflammation?

    Ballout, Ahmad A / Kolesnik, Michael / Choi, Yuna / Ayoub, Marc S / Harel, Asaff / Najjar, Souhel

    Frontiers in neurology

    2023  Volume 13, Page(s) 1084831

    Abstract: Background: The globus pallidus is a highly mitochondria-rich metabolic structure that is particularly sensitive to metabolic disturbances and hypoxia. Symmetric lesions of globus pallidus and delayed diffuse leukoencephalopathy were documented in toxic- ...

    Abstract Background: The globus pallidus is a highly mitochondria-rich metabolic structure that is particularly sensitive to metabolic disturbances and hypoxia. Symmetric lesions of globus pallidus and delayed diffuse leukoencephalopathy were documented in toxic-metabolic disorders, hypoxia, a neurodegenerative disorder, and mitochondrial encephalopathies. Similar changes are also reported in individuals with active COVID-19 infections with associated hypoxia or critical illness.
    Case information: We describe a patient with post-COVID-19 infection who presented with rapid cognitive and neurological decline associated with similar neuroimaging structural changes but without toxic-metabolic changes or hypoxia. Despite multiple non-inflammatory cerebrospinal fluid studies, mechanisms involving post-COVID-19 inflammation and immune dysregulation are suspected, given the unexplained continued decline in the neurological status, lack of concurrent hypoxia or antecedent respiratory difficulties, and after a reasonable exclusion of alternative etiologies. Hypermetabolism of both anteromedial temporal structures and diffuse hypometabolism predominantly in the frontal region on PET scan provided indirect support for possible inflammatory mechanisms after reasonable exclusion of alternative etiologies, such as direct CNS infection, among others. The patient's neurological impairment improved substantially after treatment with pulse steroids, plasmapheresis, and rituximab.
    Conclusion: To the best of our knowledge, this is the first report of post-COVID-19 with bilateral symmetric contrast-enhancing necrotic lesions of globus pallidus with delayed diffuse supratentorial leukoencephalopathy with microhemorrhages without concurrent hypoxia or reported preceding symptoms suggestive of hypoxia. We suspect that these inflammatory mechanisms might be triggered by prior COVID-19 exposure/infection. Furthermore, the role of the cross-talk between inflammation and clinically mild or silent hypoxia linked to prior COVID-19 infection cannot be excluded. Awareness of these post-COVID-19 neurological sequelae and their potential pathophysiology among those with no known antecedent significant hypoxia are important for early recognition and treatment.
    Language English
    Publishing date 2023-01-09
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2022.1084831
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Editorial: Recent Advances in Psychiatry From Psycho-Neuro-Immunology Research: Autoimmune Encephalitis, Autoimmune Encephalopathy, and Mild Encephalitis.

    Bechter, Karl / Brown, David / Najjar, Souhel

    Frontiers in psychiatry

    2019  Volume 10, Page(s) 169

    Language English
    Publishing date 2019-03-29
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2019.00169
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Autoimmune psychosis - Authors' reply.

    Pollak, Thomas A / Prüss, Harald / van Elst, Ludger Tebartz / Vincent, Angela / Najjar, Souhel / Bechter, Karl

    The lancet. Psychiatry

    2020  Volume 7, Issue 2, Page(s) 123–125

    MeSH term(s) Consensus ; Humans ; Psychotic Disorders
    Language English
    Publishing date 2020-01-22
    Publishing country England
    Document type Letter ; Comment
    ISSN 2215-0374
    ISSN (online) 2215-0374
    DOI 10.1016/S2215-0366(19)30527-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: A clinical approach to new-onset psychosis associated with immune dysregulation: the concept of autoimmune psychosis.

    Najjar, Souhel / Steiner, Johann / Najjar, Amanda / Bechter, Karl

    Journal of neuroinflammation

    2018  Volume 15, Issue 1, Page(s) 40

    Abstract: Growing data point to the overlap between psychosis and pathological processes associated with immunological dysregulation as well as inflammation. Notably, the recent discovery of antibodies against synaptic and neuronal cell membrane proteins such as ... ...

    Abstract Growing data point to the overlap between psychosis and pathological processes associated with immunological dysregulation as well as inflammation. Notably, the recent discovery of antibodies against synaptic and neuronal cell membrane proteins such as anti-N-methyl-D-aspartate receptor provides more direct evidence of the etiological connection between autoimmunity and subsequent hazard of psychosis. Here, we advocate the use of term "autoimmune psychosis," as this term suggests that autoimmune disorders can masquerade as drug-resistant primary psychosis, and this subtype of psychosis has anatomical and immunological footprints in the brain, despite the frequent absence of structural abnormalities on conventional brain MRI. Furthermore, this term might serve as a reminder not to overlook appropriate neurological workup such as neuroimaging and EEG testing, as well as CSF analysis, for cases with acute or subacute atypical onset of neuropsychiatric presentations including those dominated by acute psychotic symptoms. We propose etiologically and serologically oriented subclassification as well as multi-modal diagnostic approach to address some of the challenges inherent to early diagnosis of patients presenting with atypical and refractory new-onset psychotic symptoms of autoimmune origin. This is particularly relevant to the diagnosis of seronegative but probable autoimmune psychosis (SPAP) that might masquerade as antipsychotic drug-resistant primary psychotic disorder. This distinction is therapeutically important as autoimmune-related psychotic symptomatology can frequently respond well to timely treatment with proper immune modulatory therapies.
    MeSH term(s) Animals ; Autoantibodies/blood ; Autoimmune Diseases of the Nervous System/blood ; Autoimmune Diseases of the Nervous System/diagnosis ; Autoimmune Diseases of the Nervous System/drug therapy ; Autoimmune Diseases of the Nervous System/psychology ; Humans ; Immunologic Factors/pharmacology ; Immunologic Factors/therapeutic use ; Psychotic Disorders/blood ; Psychotic Disorders/diagnosis ; Psychotic Disorders/drug therapy ; Psychotic Disorders/psychology
    Chemical Substances Autoantibodies ; Immunologic Factors
    Language English
    Publishing date 2018-02-13
    Publishing country England
    Document type Journal Article ; Review
    ISSN 1742-2094
    ISSN (online) 1742-2094
    DOI 10.1186/s12974-018-1067-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Response to Steiner and Bogerts on N-methyl-d-aspartate receptor autoantibodies in schizophrenia and affective disorders.

    Pearlman, Daniel M / Najjar, Souhel

    Schizophrenia research

    2015  Volume 162, Issue 1-3, Page(s) 292–293

    MeSH term(s) Autoantibodies/blood ; Bipolar Disorder/immunology ; Depressive Disorder, Major/blood ; Humans ; Psychotic Disorders/immunology ; Receptors, N-Methyl-D-Aspartate/immunology ; Schizophrenia/blood
    Chemical Substances Autoantibodies ; Receptors, N-Methyl-D-Aspartate
    Language English
    Publishing date 2015-03
    Publishing country Netherlands
    Document type Comment ; Letter
    ZDB-ID 639422-x
    ISSN 1573-2509 ; 0920-9964
    ISSN (online) 1573-2509
    ISSN 0920-9964
    DOI 10.1016/j.schres.2015.01.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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