The Phenomenology of Anti-NMDA Receptor Encephalitis: A Comparison with “Primary Mental Confusion” in Late 19th Century French Psychiatry

Abstract

Background: Although various studies have been conducted on anti-NMDA receptor encephalitis since it was first reported in 2007, few studies have closely examined its clinical course. Methods: We analyzed 47 case reports of anti-NMDA receptor encephalitis that detailed its clinical course. Results: The results of our study supported the clinical course proposed by Iizuka et al. Conclusions: From the results, it is suggested that the phenomenological features understood as indicative of anti-NMDA receptor encephalitis include: (1) antecedent common cold-like symptoms (31.9%) in the prodromal phase, (2) delirium or acute confusional state (65.9%), (3) symptoms considered to be sudden personality changes (40.4%) in the psychotic phase, (4) central hypoventilation (14.9%) in the unresponsive phase, (5) motor disturbances (57.4%), and (6) autonomic symptoms, mainly without fluctuations (48.9%), in the hyperkinetic phase. These features were found to be similar to "primary mental confusion" (confusion mentale primitive) in French psychiatry in the late 19th century. We believe that classical psychiatry can contribute considerably to the interpretation of biological research results.