Anti-NMDA Receptor Encephalitis: A Need for Increased Awareness Among Psychiatrists

Abstract

Anti–N-methyl-D-aspartate (NMDA) receptor encephalitis may present with a wide variety of early neuropsychiatric symptoms such as psychosis, insomnia, catatonia, and agitation, and at times in the absence of fever. The literature highlights the vital role of psychiatrists in early recognition and timely treatment of this condition. Presence of immunoglobulin G antibodies in blood and cerebrospinal fluid (CSF) against the NR1a subunit of the NMDA receptor is considered the gold standard for confirming diagnosis. There may be other nonspecific findings in CSF and on electroencephalogram and brain magnetic resonance imaging. Management includes surgical removal of the tumor if identified, first- and second-line immunotherapy, supportive medical care, and management of psychiatric symptoms. The role of electroconvulsive therapy has been noted for treatment of catatonic symptoms in particular. [ Psychiatr Ann . 2015;45(11):572–576.]