Anti-NMDA receptor encephalitis physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] AE Dheeraj Makkar, M.D.[2]
Overview
The physical examination findings in Anti-NMDA encephalitis are non-specific. Patients may exhibit symptoms of widespread encephalopathy, altered states of consciousness, orofacial dysostosis, dyskinesis, dystonia, and autonomic storming. Neurological examination may reveal signs of diffuse cerebral dysfunction, including reflex abnormalities and mild ataxia.
Physical Examination
Common physical examination findings of Anti-NMDA encephalitis include:
- Systemic and neurological symptoms lack specificity. The clinical examination does not reveal any indicators of anti-NMDAR encephalitis.Patients exhibit symptoms of widespread encephalopathy, suggesting neurologic impairment of subcortical, limbic, and frontostriatal circuitry. Some features of neurological disorders include
- orofacial dysostosis, dyskinesis, choreoathetosis, dystonia, oculogyric crises, stiffness, pelvic thrusting and opisthotonic posture.
- Multiple altered states of consciousness are possible. Infrequently, signs of elevated intracranial pressure may be observed in the aftermath of protracted status epilepticus.
- In addition to mobility difficulties, a neurologic examination may reveal nonspecific symptoms of diffuse cerebral dysfunction, such as increased deep tendon reflexes, extensor plantar responses, and tone abnormalities.
- Soft neurologic symptoms, including mild ataxia and difficulty with fine motor coordination, may also be present.
- tachycardia and hypertension, are signs of autonomic storming in patients.
References
- ↑ Dalmau J, Gleichman AJ, Hughes EG, Rossi JE, Peng X, Lai M; et al. (2008). "Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies". Lancet Neurol. 7 (12): 1091–8. doi:10.1016/S1474-4422(08)70224-2. PMC 2607118. PMID 18851928.
- ↑ Titulaer MJ, McCracken L, Gabilondo I, Iizuka T, Kawachi I, Bataller L; et al. (2013). "Late-onset anti-NMDA receptor encephalitis". Neurology. 81 (12): 1058–63. doi:10.1212/WNL.0b013e3182a4a49c. PMC 3795591. PMID 23946310.