Anti-NMDA receptor encephalitis: psychiatric presentation and diagnostic challenges from psychosomatic medicine perspective

Palliat Support Care. 2014 Apr;12(2):159-63. doi: 10.1017/S1478951513000515.

Abstract

We describe two cases of confirmed anti-NMDA receptor encephalitis; one patient initially presented with a clinical picture that resembled delirium and later appeared to present with a conversion reaction and the second patient presented with a first psychotic break followed by the clinical picture of neuroleptic malignant syndrome with catatonia. Neither patient had a previous history of psychiatric illness or recreational drug use. These cases illustrate the diagnostic and treatment challenges associated with this neuropsychiatric condition and underscore the role of psychosomatic medicine psychiatrists in diagnosing anti-NMDA receptor encephalitis.

Publication types

  • Case Reports

MeSH terms

  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / cerebrospinal fluid
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis*
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / drug therapy
  • Catatonia / diagnosis
  • Catatonia / etiology
  • Delirium / diagnosis
  • Delirium / etiology
  • Diagnosis, Differential
  • Electroencephalography
  • Female
  • Humans
  • Neuroimaging
  • Psychosomatic Medicine / methods*
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / etiology
  • Receptors, N-Methyl-D-Aspartate / immunology*
  • Seizures / diagnosis
  • Seizures / etiology
  • Young Adult

Substances

  • Receptors, N-Methyl-D-Aspartate