Anti-nmda Receptor Encephalitis In A Young Girl With Altered Behaviour And Abnormal Movements

Abstract

Autoimmune encephalitis is a rare central nervous system disorder in which the patient presents with neuropsychiatric symptoms. We herein present a case of anti-NMDA receptor encephalitis in which the patient initially presented in the psychiatric department. A 14-year girl was brought with complains of irritability, altered behaviour, abnormal movements, self biting, and decreased sleep for the past 10 days. Her condition deteriorated during the admission and she became mute, immobile, and drowsy. Her baseline investigations and CT scan brain were normal. CPK was high and the CSF showed pleocytosis. Autoimmune encephalitis profile showed presence of antibodies against the NMDA receptors. Improvement in the symptoms was noted after treatment with steroids and plasmapharesis. This case report highlights the importance of multidisciplinary approach involving the neurologist, psychiatrist, and immunologist in accurately diagnosing and managing a rare neurological disorder presenting mainly with psychiatric symptoms.

Experience with anti NMDA receptor antibody encephalitis in a tertiary care hospital in Pakistan

“…A total of seven patients were diagnosed as having Anti-NMDAR antibody encephalitis (Table 1). 6,7 Demography: Patient population in this case series ranged from 14-30 years of age with the mean age being 19 years. Five patients were female and two were male.…”

Plasmapheresis in Neurological Disorders: Frequency and Type of Adverse Effects Associated with this Procedure in Atertiary Care Hospital in Pakistan

“…Steroid therapies, plasmapheresis and intravenous immunoglobulin have been a few methods which have been used in this regard to managing the disorders with an immunological basis, either autoimmune or secondary to some other process. [4][5][6] Plasmapheresis has been in clinical use for various disorders for years now. Despite its efficacy in immune-based disorders and quick response in the acute phase of many illnesses, it has certain untoward effects, which should be in knowledge by the treating physician and the patient to manage them effectively.…”