Anti-NMDA receptor encephalitis: a case study and illness overview

Drugs in Context

article

Brian Ford¹  Alex McDonald²  Shilpa Srinivasan³ 

[1] PGY-4 Resident Psychiatrist, Palmetto Health-University of South Carolina Psychiatry Residency Program;Consult-Liaison Psychiatrist, Palmetto Health-University of South Carolina Medical Group;Department of Neuropsychiatry and Behavioral Science, Palmetto Health-University of South Carolina Medical Group

关键词: anti-NMDAR;    autoimmune encephalitis;    encephalitis;    NMDA.;   

DOI  :  10.7573/dic.212589

学科分类：社会科学、人文和艺术（综合）

来源: C S F Medical Communications Ltd.

【 摘 要 】

Anti-N-methyl D-aspartate (NMDA) receptor (anti-NMDAR)encephalitis is among one of the most common autoimmuneencephalitides. However, variations in clinical presentationand nonsequential multiphasic course often lead to delaysin diagnosis. The mild encephalitis (ME) hypothesis suggestsa pathogenetic mechanism of low-level neuroinflammationsharing symptom overlap between anti-NMDAR encephalitisand other psychiatric disorders including schizophrenia.Clinical symptoms of anti-NMDAR encephalitis may mimicschizophrenia and psychotic spectrum disorders or substanceinduced psychosis. Although initially described in associationwith ovarian teratomas in women, anti-NMDAR encephalitishas been reported in individuals without paraneoplasticassociation, as well as in males. It can affect all age groupsbut is usually lower in prevalence in individuals greater than50 years old, and it affects females more than males. Clinicalevaluation is supported by laboratory workup, which includescerebrospinal fluid (CSF) assays. The latter often revealslymphocytic pleocytosis or oligoclonal bands with normal toelevated CSF protein. CSF testing for anti-NMDAR antibodiesfacilitates diagnostic confirmation. Serum anti-NMDAR antibodyassays are not as sensitive as CSF assays. Management includessymptomatic treatment and immunotherapy.

【 授权许可】

CC BY-NC-ND