Currently, among psychiatrists and in the special scientific and medical literature, there is no consensus on the etiology and pathogenesis of the development of schizophrenia. In the clinic of Professor V.L. Minutes in Moscow, in the treatment of this disease, they are of the opinion that herpes viruses are involved in the genesis of schizophrenia. When activated, the cause of which is a decrease in immunity, autoimmune limbic encephalitis occurs against the background of concomitant infectious diseases. With this disease, mild inflammation is found in some areas of the brain – the medial part of the temporal lobe, the orbitofrontal and frontal basal regions of the brain.
Treatment of schizophrenia, in terms of the presence of inflammatory changes in the brain, is the prerogative of our clinic and is not practiced anywhere else in Moscow.
Typically, inflammatory processes in the above areas of the brain are paraneoplastic . And at this point in time, the mechanism of the pathogenesis of autoimmune encephalitis is unknown, but most likely antibodies directed against the intracellular and membrane antigens of neurons are involved . These are antibodies to the NMDA receptors of neurons and to the calcium channels of the neuronal membrane. Possibly, antibodies to AMPA and GABA receptors of the second type are involved in the pathogenesis.
Research of the clinic V.L. A minute about the effectiveness of treatment, taking into account the autoimmune theory of schizophrenia, is confirmed by foreign scientists. In Russian science, there is a traditional approach to the causes and treatment of this disease, which hinders the search for new methods of treating schizophrenia.
If we compare the clinical manifestations of autoimmune encephalitis and schizophrenia, we can find many similarities in the dynamics of these two diseases. Namely phase character of the process: the prodromal phase of psychosis phase, the phase of negative syndromes, hyperkinetic phase.
In the prodromal phase, we observe symptoms such as:
- subfebrile temperature;
- weakness;
- headache;
- psychotic syndromes (apathy, anxiety, phobias, mood swings, hallucinations, delusions of persecution, sleep disturbances, obsessive states).
In classic autoimmune limbic encephalitis, more pronounced organic damage can be seen in psychosis, manifested by:
- tonic-clonic seizures;
- convulsive syndrome.
In schizophrenia, autoimmune limbic encephalitis has an atypical course, therefore, the use of autoimmunotherapy and anti-inflammatory drugs allows more balanced treatment in our clinic.
Prescribing anti-inflammatory drugs is relevant in the treatment of schizophrenia. So, during the study, a change in C-reactive protein is observed, the emergence of antibodies to streptolysin , G- gliadin and glutamate transferase .
Therefore, the use of drugs such as celecoxib or small doses of corticosteroids is reasonable.
If schizophrenia occurs with the presence of autoimmune processes provoked by a viral infection and pathomorphological changes in the neuroglia (proliferation of microglia and astroglia ), then they can be detected on electroencephalography.
At the same time, the EEG shows indistinct local changes – bilateral synchronous discharges of theta waves, with an increased amplitude in the left hemisphere.
A complete blood count in patients with schizophrenia reveals leukocytosis – an increased number of leukocytes. A number of researchers with autoimmune limbic encephalitis found an increased titer of enteroviruses, cryptococci , cytomegalovirus, toxoplasma, and Epstein-Barr virus.
In the clinic of Dr. V.L. Minute, where many patients with schizophrenia were examined and treated, the dynamics of the neurotest reflected changes in glutamatergic receptors (NMDA receptors).
These indicators, plus data on brain bioelectrical activity, can be used as markers of schizophrenia, in the genesis of which autoimmune limbic encephalitis is involved. Treatment of schizophrenia is best done by examining autoimmune damage to the limbic system of the brain, then the effectiveness of therapy increases many times.