Anti-NMDA Receptor Encephalitis: Diagnosis, Psychiatric Presentation, and Treatment

A growing literature describes the clinical presentation, diagnosis, and pathophysiology of anti-NMDA (N-methyl-D-aspartic acid) receptor encephalitis. Once conceptualized as a condition primarily affecting adult women and frequently associated with tumors, anti-NMDA receptor encephalitis is increas...

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Bibliographic Details
Published in:American Journal of Psychiatry 2011-03, Vol.168 (3), p.245-251
Main Authors: Chapman, Meredith R, Vause, Holly E
Format: Article
Language:English
Subjects:
Adolescent
Behavior
Behavioral Symptoms - drug therapy
Biological and medical sciences
Diagnosis, Differential
Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes
Encephalitis - diagnosis
Encephalitis - drug therapy
Encephalitis - immunology
Hospitalization
Humans
Hypertension
Immunoglobulins, Intravenous - therapeutic use
Kinases
Lymphocytes
Male
Medical imaging
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Nosology. Terminology. Diagnostic criteria
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Receptors, N-Methyl-D-Aspartate - antagonists & inhibitors
Receptors, N-Methyl-D-Aspartate - immunology
Syndrome
Techniques and methods
Tumors
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Summary:A growing literature describes the clinical presentation, diagnosis, and pathophysiology of anti-NMDA (N-methyl-D-aspartic acid) receptor encephalitis. Once conceptualized as a condition primarily affecting adult women and frequently associated with tumors, anti-NMDA receptor encephalitis is increasingly recognized in males, in children, and in the absence of tumors. Despite the expanding knowledge base, much remains to be understood about effective treatments. The little available management and immunotherapy to control the anti-body response. Limited information is available on the management of psychiatric symptoms in these complex, often critically ill patients. Here we describe, through an illustrative case example, the clinical characteristics of anti-NMDA receptor encephalitis in an adolescent male. We also outline other disease processes to be considered in the differential diagnosis and describe currently used interventions, including psychotropic medications. [PUBLICATION ABSTRACT]
ISSN:0002-953X
1535-7228
DOI:10.1176/appi.ajp.2010.10020181