Anti-NMDAR encephalitis

From IDWiki

Background

  • Relatively common cause of autoimmune encephalitis
  • More common in women of childbearing age (18 to 45)
  • Associated with ovarian teratoma and sometimes other tumours
  • Pathophysiology is from the production of IgG antibodies targetting NMDA receptors

Clinical Manifestations

  • Myriad symptoms
  • Subacute presentation that can be organised into:
    • Prodromal phase, with flu-like illness last weeks up to a few months
    • Psychotic phase, with variable psychiatric manifestations, with fairly rapid onset sometimes prompting admission to psychiatric units
    • Unresponsive phase
    • Hyperkinetic phase, usually oro-lingual dyskinesia (lip-smacking, tongue protrusion, jaw movements), but can be a variety of movement disorders
    • Recover phase

Diagnosis

  • Anti-NMDAR IgG antibodies, detected by indirect immunofluorescence assay in the serum and the CSF