Anti-NMDA receptor encephalitis history and symptoms

Jump to navigation Jump to search

Anti-NMDA receptor encephalitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Anti-NMDA receptor encephalitis from Other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications, and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Anti-NMDA receptor encephalitis history and symptoms On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Anti-NMDA receptor encephalitis history and symptoms

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Anti-NMDA receptor encephalitis history and symptoms

CDC on Anti-NMDA receptor encephalitis history and symptoms

Anti-NMDA receptor encephalitis history and symptoms in the news

Blogs on Anti-NMDA receptor encephalitis history and symptoms

Directions to Hospitals Treating Anti-NMDA receptor encephalitis

Risk calculators and risk factors for Anti-NMDA receptor encephalitis history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] AE Dheeraj Makkar, M.D.[2]

Overview

Anti-NMDA receptor encephalitis presents with neuropsychiatric manifestations, neurological symptoms, altered consciousness, and a subacute time frame. Early recognition is important for prompt intervention.

History

The most common symptoms of Anti-NMDA receptor encephalitis include Neuropsychiatric Manifestations, Neurological Symptoms, Altered Consciousness and varied time frame of symptoms.

1. Neuropsychiatric Manifestations: The patient may exhibit behavioral changes, mood disturbances, including irritability, anxiety, or depression. They may also experience hallucinations both auditory and visual and exhibit signs of psychosis such as delusions or disorganized thinking. These symptoms are often mistaken for primary psychiatric disorders initially.

2. Neurological Symptoms: The patient may develop seizures, which can manifest as generalized convulsions or focal seizures involving specific body parts. They may also experience abnormal movements such as dyskinesias (involuntary, repetitive movements) or dystonia (sustained muscle contractions causing twisting or repetitive movements). Speech problems, such as slurred speech or difficulty finding words, may also be present. Autonomic dysregulation can manifest as changes in blood pressure, heart rate, or body temperature.

3. Altered Consciousness: As the disease progresses, the patient's level of consciousness may decrease, leading to confusion, disorientation, or even coma. Catatonia, a state of immobility or unresponsiveness, may occur. Hypoventilation, characterized by shallow or irregular breathing, can also be observed. Abnormal movements, such as stereotypical or repetitive motions, may be present.

4. Varied Time Frame: The symptoms typically have a subacute onset, gradually worsening over weeks or months. The duration of symptoms can vary, and early recognition is crucial for timely intervention and treatment.

Symptoms

Anti-NMDAR encephalitis manifests as a condition that manifests in stages of progressive disease and recovery.

  • The majority of patients exhibit five phases of clinical presentation: a prodromal stage, psychotic and/or seizure phase, unresponsive and/or catatonic phase, hyperkinetic phase, and gradual recovery phase.

Prodromal Features occur mainly in children and include:

Other features are:

Symptoms
Psychiatric symptoms Neurologic symptoms
  • anxiety,
  • paranoia,
  • fear ,
  • psychosis
  • mania
  • insomnia
Movement Disorder : Orofacial dyskinesis are characterized by motions such as
  • Chewing, tongue protrusion, lip smacking, and facial grimacing
  • Pelvic thrusting, pseudo-piano playing gestures, and extremity writhing
  • Oculogyric crisis
  • Dystonia

Autonomic features:

  • Tachycardia, hypertension, and hyperthermia
  • Less commonly hypersalivation, urinary incontinence

Seizures:

  • Partial and generalized seizures, as well as status epilepticus, are possible, but partial seizures tend to predominate.
  • Unexplained new onset epilepsy in young women

Cognitive problems

Anti-NMDAR encephalitis has also been documented in a female adolescent with severe longitudinal myelitis and optic neuritis mimicking neuromyelitis optica and repeated relapses.

References

[1] [2] Template:WH Template:WS

  1. 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.
  2. Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T; et al. (2016). "A clinical approach to diagnosis of autoimmune encephalitis". Lancet Neurol. 15 (4): 391–404. doi:10.1016/S1474-4422(15)00401-9. PMC 5066574. PMID 26906964.