PS-R03-11: ANTI-NMDA RECEPTOR ENCEPHALITIS: SEIZURES AND PSYCHOSIS: A CASE REPORT ABOUT 18-YEAR OLD ADMITTED AT ARMMC

Abstract

Introduction: Anti-NMDA receptor encephalitis is one of many autoimmune diseases that need further recognization. Its signs and symptoms are indefinite and there is no specific pathognomic sign that can be use to properly diagnosed the disease immediately. Therefore more often these patients are prone to misdiagnosis. Many reports claimed that it is directly associated with ovarian teratomas in women though in some reports it can also be seen in males. This case helps in further recognizing anti-NMDA receptor encephalitis especially in our country where there are only few cases reported. Case: The case presented is about an 18-year old female from Mindoro Philippines who was previously well and had sudden changes in behavior with seizures episodes. Patient had consult at their local hospital where she was being treated as a case of viral meningitis but apparently no improvement was noted and subsequently transferred to a tertiary hospital in Metro Manila for further evaluation and management. During her hospital stay at Amang Rodriguez Memorial Medical Center patient presented as seizures with abnormal psychiatric features where she was eventually suspected to have anti-NMDA (anti-N-methyl-D-aspartate) receptor encephalitis but further testing was done initially to rule out other neurologic diseases. Almost all laboratories and radiologic tests turn out to be normal hence a video electroencephalogram (EEG) was requested and result was that the patient is suggestive to have the said disease. Definitive test for anti-NMDA receptor encephalitis was done which turned out positive. The patient was then treated as a case of anti-NMDA receptor encephalitis and manage accordingly. Improvement was noted and the patient was then discharged subsequently. Conclusion: There may be increasing cases of anti-NMDA receptor encephalitis worldwide further research must still be done to be able to understand its features diagnose and manage it appropriately. And since it is more common in young adult females anti-NMDA receptor encephalitis must be suspected and be taken into consideration when there is a patient who presented with sudden changes in behavior with psychosis and seizures.