A Combined Behavioral and Pharmacological Approach in Nonparaneoplastic-Related Anti-N-Methyl-D-Aspartate Receptor Encephalitis

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a rare but potentially life-threatening and disabling autoimmune encephalitis mainly affecting young women. We report the case of a male in his early thirties who developed behavioral and neurocognitive manifestations of anti-NMDAR encephalitis. This case highlights the unique behavioral challenges in a male patient during the course of rehabilitation, including impulsivity, inappropriate sexual behavior, and hyperphagia, which has not been well-described in the literature. This presented complex problems for the rehabilitation team and amelioration of these clinical issues required a multidisciplinary approach. The behavioral and pharmacological strategies employed, which had a pronounced positive contribution in this patient, are described. A brief review of the epidemiology, course, and common complications of anti-NMDAR encephalitis is also presented.