Unmasking bipolarity in recurrent depressive disorder following herpes simplex virus triggered n-methyl-D-aspartate encephalitis

Bipolar Disord. 2024 Mar;26(2):192-195. doi: 10.1111/bdi.13393. Epub 2023 Nov 16.

Abstract

Objective: Herpes simplex virus (HSV) infection triggered n-methyl-D-aspartate (NMDA) encephalitis can lead to varied neuropsychiatric manifestations, including movement disorders and manic symptoms. HSV is known to affect the same brain regions as in secondary mania.

Method: We present a 35-year-old female diagnosed with recurrent depressive disorder (RDD) who developed NMDA encephalitis triggered by HSV infection.

Result: HSV-triggered NMDA encephalitis led to a manic switch in a woman with RDD on antidepressants, along with the new onset of dyskinetic movements.

Conclusion: A neurological insult predisposed our patient to the variable effects of antidepressant drugs.

Keywords: NMDA encephalitis; bipolarity; herpes simplex encephalitis; recurrent depression.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis* / complications
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis* / diagnosis
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis* / drug therapy
  • Autoantibodies
  • Bipolar Disorder* / complications
  • Bipolar Disorder* / drug therapy
  • Depressive Disorder*
  • Encephalitis, Herpes Simplex* / complications
  • Encephalitis, Herpes Simplex* / diagnosis
  • Encephalitis, Herpes Simplex* / drug therapy
  • Female
  • Humans
  • Mania
  • N-Methylaspartate
  • Simplexvirus

Substances

  • N-Methylaspartate
  • Autoantibodies