Cotard syndrome in anti-NMDAR encephalitis: two patients and insights from molecular imaging.
Jesús Ramírez-BermúdezP Bustamante-GomezM Espínola-NadurilleN E KerikI E Dias MenesesMiguel Restrepo-MartinezM F MendezPublished in: Neurocase (2021)
Cotard syndrome is a clinical condition defined by the presence of nihilistic delusions. We report two patients with Cotard syndrome in whom anti-NMDAR encephalitis (ANMDARE) was confirmed. Both cases showed features of affective psychosis, developed catatonic syndrome, and worsened after the use of antipsychotics. 18F-FDG PET brain studies showed a bilateral hemispheric pattern of hypometabolism in posterior regions, mainly in the cingulate cortex and in the medial aspects of parietal and occipital lobes. A more severe hypometabolism was observed in the right hemisphere of both patients. Both cases remitted with the use of specific immunotherapy for ANMDARE.
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