PMID- 33799161
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1532-2777 (Electronic)
IS  - 0306-9877 (Linking)
VI  - 150
DP  - 2021 May
TI  - Hystero-epilepsy in the Tuesday Lessons and NMDA receptor function: A hypothesis 
      for dissociative disorder.
PG  - 110567
LID - S0306-9877(21)00085-2 [pii]
LID - 10.1016/j.mehy.2021.110567 [doi]
AB  - Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patients demonstrate 
      characteristic multistage progression and movement disorders, which are analogous 
      to hystero-epilepsy in Jean-Martin Charcot's Tuesday Lessons. First, based on a 
      review of the Tuesday Lessons recorded by Charcot's pupils, we hypothesized that 
      there were patients with anti-NMDAR encephalitis among those diagnosed with 
      hystero-epilepsy in the nineteenth century. We found acute-onset multiple 
      neuropsychiatric manifestations resembling anti-NMDAR encephalitis among patients 
      with hystero-epilepsy. Patients with drug withdrawal syndrome, dissociative and 
      conversion disorders and patients under hypnosis from the modern point of view 
      were also identified. These results suggested that hystero-epilepsy in the 
      Tuesday Lessons could encompass dissociative and conversion disorders, hypnosis, 
      drug withdrawal syndrome, and anti-NMDAR encephalitis-like manifestations. Based 
      on Charcot's observations and current progress in molecular biology, such as the 
      identification of glutamate/NMDAR system dysfunction in drug withdrawal syndrome, 
      we then hypothesized that patients with dissociative and conversion disorders and 
      those under hypnosis could also have hypofunction of the glutamatergic system. 
      The NMDAR hypofunction hypothesis is emerging as a pathogenesis of schizophrenia. 
      NMDAR antagonists are known to evoke symptoms similar to schizophrenia, 
      anti-NMDAR encephalitis and near-death experiences. In current clinical reports, 
      spectrum disorders such as dissociative disorder and conversion disorder have 
      been observed in patients with anti-NMDAR encephalitis. Our hypothesis will offer 
      an expansion of the NMDAR hypofunction hypothesis from psychosis to functional 
      neurological disorders and normal specific situations, such as hypnosis, 
      thanatosis, and near-death experiences.
CI  - Copyright (c) 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.
FAU - Komagamine, Tomoko
AU  - Komagamine T
AD  - Department of Neurology, Dokkyo Medical University, Japan. Electronic address: 
      tkoma@dokkyomed.ac.jp.
FAU - Kokubun, Norito
AU  - Kokubun N
AD  - Department of Neurology, Dokkyo Medical University, Japan. Electronic address: 
      kokubun@dokkyomed.ac.jp.
FAU - Hirata, Koichi
AU  - Hirata K
AD  - Department of Neurology, Dokkyo Medical University, Japan. Electronic address: 
      hirata@dokkyomed.ac.jp.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210323
PL  - United States
TA  - Med Hypotheses
JT  - Medical hypotheses
JID - 7505668
RN  - 0 (Receptors, Glutamate)
RN  - 0 (Receptors, N-Methyl-D-Aspartate)
SB  - IM
MH  - *Anti-N-Methyl-D-Aspartate Receptor Encephalitis
MH  - Dissociative Disorders
MH  - *Epilepsy/complications
MH  - Humans
MH  - Receptors, Glutamate
MH  - Receptors, N-Methyl-D-Aspartate
OTO - NOTNLM
OT  - Autoimmune encephalitis
OT  - History
OT  - Hysteria
OT  - Ketamine
OT  - Tonic immobility
EDAT- 2021/04/03 06:00
MHDA- 2021/05/15 06:00
CRDT- 2021/04/02 20:34
PHST- 2020/12/01 00:00 [received]
PHST- 2021/02/16 00:00 [revised]
PHST- 2021/03/09 00:00 [accepted]
PHST- 2021/04/03 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2021/04/02 20:34 [entrez]
AID - S0306-9877(21)00085-2 [pii]
AID - 10.1016/j.mehy.2021.110567 [doi]
PST - ppublish
SO  - Med Hypotheses. 2021 May;150:110567. doi: 10.1016/j.mehy.2021.110567. Epub 2021 
      Mar 23.