Clinical Aspects of Anti-NMDA Receptor Encephalitis

Shimazaki, Hideyuki

doi:10.5772/20718

Cited by 6 publications

(9 citation statements)

References 29 publications

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“…While the majority of cases described to date follow the clinical progression described above, there is increasing awareness that atypical forms8 9 of anti-NMDAR encephalitis exist which present with prominent psychiatric symptoms 9–11. The presentation in this instance as an acute psychosis mimicking schizophrenia and the excellent response to immunotherapy highlights the critical importance of raising awareness of this disorder and its expanding phenotype, particularly within clinicians working in acute psychiatric services.…”

Section: Introductionmentioning

confidence: 99%

Autoimmune limbic encephalitis presenting as relapsing psychosis

Hopkins¹,

Moodley

Chan

2013

BMJ Case Reports

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A 34-year-old woman with a history of relapsing psychosis presented with a 15-month history of impassivity and social withdrawal associated with cognitive impairment. The subsequent recurrence of psychomotor agitation, auditory hallucinations and delusional thinking resulted in an emergency admission under psychiatric services. Initial investigations, including MRI of the brain and cerebrospinal fluid studies were unremarkable and she was treated for a primary psychiatric disorder. The diagnosis of autoimmune limbic encephalitis was established after further investigations revealed the presence of antibodies to the NR1 subunit of theN-Methyl-d-aspartate receptor (NMDAR). Immunotherapy resulted in rapid resolution of psychosis and marked improvement in cognitive and social function. This case underlines the importance of considering anti-NMDAR encephalitis within the differential diagnosis of psychosis associated with cognitive impairment even in those with an apparent previous psychiatric history and response to antipsychotics.

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Section: Introductionmentioning

confidence: 99%

Autoimmune limbic encephalitis presenting as relapsing psychosis

Hopkins¹,

Moodley

Chan

2013

BMJ Case Reports

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“…10 Anti-NMDA receptor encephalitis is the most common form of immune-mediated encephalitis, defined by the presence of immunoglobulin G antibodies against the NR1 subunit of the NMDA receptors in the central nervous system (CNS). 11 Acute or subacute neuropsychiatric symptoms are the most common manifestations and early diagnosis and immunotherapy are crucial to achieve full recovery. 11 Similarly, most cases of definite autoimmune encephalitis related to COVID-19 infection or vaccination were of the anti-NMDA receptor type.…”

Section: Discussionmentioning

confidence: 99%

“…11 Acute or subacute neuropsychiatric symptoms are the most common manifestations and early diagnosis and immunotherapy are crucial to achieve full recovery. 11 Similarly, most cases of definite autoimmune encephalitis related to COVID-19 infection or vaccination were of the anti-NMDA receptor type. 10 COVID-19 vaccine-associated autoimmune encephalitis was identified in 14 cases with temporal association to SARS-CoV-2 vaccination, the average age was 32 years with female predominance.…”

Section: Discussionmentioning

confidence: 99%

“…Other reported neurological adverse events included COVID-19 vaccineinduced immune thrombotic thrombocytopenia and related cerebral thrombosis, demyelination disorders such as neuromyelitis optica spectrum disorders, myelin oligodendrocyte glycoprotein antibody associated disease, multiple sclerosis, acute hemorrhagic encephalomyelitis, and optic neuritis (10). Anti-NMDAR encephalitis the commonest form of immune-mediated encephalitis, defined by the presence of immunoglobulin G (IgG) antibodies against the NR1 subunit of the NMDA receptors in the CNS (11). Acute or subacute neuropsychiatric symptoms are the most common manifestations and early diagnosis, and immunotherapy is crucial to achieve the full recovery (11).…”

Section: Discussionmentioning

confidence: 99%

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Anti-NMDA Autoimmune Encephalitis Post-COVID-19 Vaccination in a Pediatric Patient: A Case Report

Alabssi,

Almulhim,

Al-Omari

et al. 2023

Neuropediatrics

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Post-coronavirus disease (COVID-19) vaccination encephalitis is rarely reported particularly in the pediatric population. Herein, we report the first case of post-vaccination anti-NMDA encephalitis in close temporal association with receiving COVID-19 vaccine in a pediatric patient. The patient is a 13-year-old female who received the first dose of the Pfizer–BioNTech COVID-19 vaccine and presented with subacute neurological and psychiatric symptoms and eventually confirmed the diagnosis of anti-NMDA autoimmune encephalitis. The patient recovered after receiving intravenous immunoglobulins and steroids.

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“…NMDA receptors are tetramers composed of NR1 subunits and two of the four NR2 (A-D) subunits [59]. Anti-NMDAR encephalitis is an autoimmune neurological condition associated with SLE; however, its pathophysiology is not fully understood [60,61]. Anti-NR2 antibodies cross-react with anti-double-stranded DNA antibodies [62].…”

Section: Anti-human N-methyl-d-aspartate Receptor Abs (Anti-nmda)mentioning

confidence: 99%

Neuropsychiatric Systemic Lupus Erythematosus: Antibodies Involved, Clinical Characteristics and Treatment

Gopaul,

Vaillant

2023

Preprint

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Systemic lupus erythematosus (SLE) is a chronic idiopathic autoimmune disease affecting various organs. Patients with SLE also present numerous neuropsychiatric manifestations. These neuro-psychiatric manifestations are referred to as neuropsychiatric systemic lupus erythematosus (NPSLE). Neuropsychiatric involvement in patients with SLE was first mentioned by Kaposi more than 100 years ago and is a generic term that refers to neurological and psychiatric symp-toms resulting directly from or as a complication of SLE. NPSLE affects both the CNS and PNS and can manifest as various symptoms, such as cognitive dysfunction, organic brain syndromes, delirium, seizures, headache, and psychosis. NPSLE was previously referred to as ‘lupus cerebri-tis’ or lupus sclerosis. However, these terms are no longer recommended because there is no de-finitive pathological cause for the neuropsychiatric manifestations of SLE.[2]

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Clinical Aspects of Anti-NMDA Receptor Encephalitis

Cited by 6 publications

References 29 publications

Autoimmune limbic encephalitis presenting as relapsing psychosis

Autoimmune limbic encephalitis presenting as relapsing psychosis

Anti-NMDA Autoimmune Encephalitis Post-COVID-19 Vaccination in a Pediatric Patient: A Case Report

Neuropsychiatric Systemic Lupus Erythematosus: Antibodies Involved, Clinical Characteristics and Treatment

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