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About

Anti–NMDA receptor encephalitis (anti-NMDARE) antibody disease is an acute form of encephalitis that is potentially lethal but has a high probability for recovery with treatment. It is caused by an autoimmune reaction, mediated by autoantibodies that target NMDA receptors in the brain. The symptoms typically progress from flu-like symptoms to neurological and behavioral effects that often include agitation, paranoia, psychosis, and violent behaviors. Other common initial manifestations include seizures and bizarre physical movements, impaired cognition, memory deficits, and speech problems. As the disease progresses, the symptoms become more severe and medically urgent, and often include autonomic dysfunction, hypoventilation, cerebellar ataxia, hemiparesis, loss of consciousness, or catatonia.

Occurrence

The symptoms usually appear psychiatric in nature, which may confound the differential diagnosis. In many cases, this leads to a misdiagnosis and, therefore, the current overall incidence of the condition is unknown.

Treatment & Prognosis

If patients are found to have a tumor, the long-term prognosis is generally better and the chance of relapse is much lower. This is because the tumor can be removed surgically, thus eradicating the source of auto-antibodies. In general, early diagnosis and aggressive treatment is believed to improve patient outcomes.The recovery process from anti-NMDA encephalitis can take many months. Treatments include:

• Plasmapheresis
• Immunosuppression (via steroids, cyclophosphamide)
• IVIG
• Rituximab
• Physical, Speech, Occupational therapies