A child with anti-N-methyl-D-aspartate autoimmune encephalitis presenting with frank psychosis: a case report

Abstract

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is the most common autoimmune encephalitis in children. The clinical manifestations and disease course of pediatric anti-NMDA receptor encephalitis have been comprehensively desibed in the literature and showed some differences compared with adult patients in tumor association, neurological presentation, and frequency of symptoms. In general, neurological symptoms were more common than psychiatric symptoms as the initial signs of presentation in children in most of the previous cohorts. They also tend to present with behavior changes, temper tantrums, hyperactivity, and irritability, instead of overt psychotic symptoms. In this article, we report a 12 years old boy with Anti NMDA encephalitis, showing a rare initial presentation of pure psychosis, after obtaining the consent of his parents.