Eastern Journal of Psychiatry

Register      Login

VOLUME 23 , ISSUE 1 ( January-June, 2020 ) > List of Articles


Anti-N-methyl-D-aspartate Receptor Antibody Encephalitis: A Psychiatric Presentation

BS Suganya Priyadharshini

Keywords : Acute psychosis, Anti-NMDA receptor antibody encephalitis, Catatonia.

Citation Information : Priyadharshini BS. Anti-N-methyl-D-aspartate Receptor Antibody Encephalitis: A Psychiatric Presentation. 2020; 23 (1):32-33.

DOI: 10.5005/jp-journals-11001-0001

License: CC BY-NC 4.0

Published Online: 15-11-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Anti-N-Methyl D-aspartate receptor (anti-NMDA-R) encephalitis is an underdiagnosed autoimmune condition that can present with “flu” like illness that progresses through stages of psychotic symptoms and movement disorders that further deteriorates to autonomic instability and even death if not treated promptly. The case condition often presents to psychiatrists who may find the condition not responding to standard treatments posing significant diagnostic challenges. Often it can present as a paraneoplastic syndrome, but recent data shows the occurrence of idiopathic presentations. Here we present of a 40-year-old male with one such typical clinical presentation of psychotic symptoms along with movement abnormalities and progression to further neurological deterioration who after systemic evaluation was diagnosed to be a case of anti-NMDA-R encephalitis. He responded well to IVIG and plasma exchange. There is a need to recognize this condition more vigilantly in practice and the factors favoring prognosis and outcomes are further discussed.

  1. Dalmau J, Gleichman AJ, Hughes EG, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects ofantibodies. Lancet Neurol 2008;7:1091–8. DOI: 10.1016/S1474-4422(08)70224-2
  2. Dalmau J, Lancaster E, Martinez-Hernandez E, et al. Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. Lancet Neurol 2011;10:63–74. DOI: 10.1016/S1474-4422(10)70253-2
  3. Maramatta BV, Jacob A. N-methyl D-aspartate receptor encephalitis: a new addition to the spectrum of autoimmune encephalitis. Ann Indian Acad Neurol.2011;14 July–September(3):153-157. DOI: 10.4103/0972-2327.85872
  4. Granerod J, Ambrose HE, Davies NW, et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis 2010;10:835–844. DOI: 10.1016/S1473-3099(10)70222-X
  5. Titulaer MJ, McCracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol 2013;12:157–165. DOI: 10.1016/S1474-4422(12)70310-1
  6. Maneta E, Garcia G. Psychiatric manifestations of anti-NMDA receptor encephalitis: neurobiological underpinnings and differential diagnostic implications. Psychosomatics 2014;55:37–44. DOI: 10.1016/j.psym.2013.06.002
  7. Gable MS, Sheriff H, Dalmau J, et al. The frequency of autoimmune N-methyl-D-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project. Clin Infect Dis 2012;54:899–904. DOI: 10.1093/cid/cir1038
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.