Anti-NMDA Receptor Encephalitis: Diagnosis, Psychiatric Presentation, and Treatment

Abstract

A growing literature describes the clinical presen- tation, diagnosis, and pathophysiology of anti-NMDA (N-methyl-d-aspartic acid) receptor encephalitis. Once conceptualized as a condition primarily affecting adult women and frequently associated with tumors, anti- NMDA receptor encephalitis is increasingly recognized in males, in children, and in the absence of tumors. Despite the expanding knowledge base, much remains to be un- derstood about effective treatments. The little available information on management focuses primarily on tumor management and immunotherapy to control the anti- body response. Limited information is available on the management of psychiatric symptoms in these complex, often critically ill patients. Here we describe, through an illustrative case example, the clinical characteristics of anti-NMDA receptor encephalitis in an adolescent male. We also outline other disease processes to be considered in the differential diagnosis and describe currently used interventions, including psychotropic medications.