Anti-N-Methyl-D-Aspartate-Receptor Encephalitis, a Challenge for Neurologists or a Chameleon for Psychiatrists: A Case Report

Abstract

Anti-N-Methyl-D-Aspartate-Receptor (NMDA-R) encephalitis is a new autoimmune disorder, often paraneoplastic in nature, presenting with complex neuropsychiatric symptoms. Diagnosed serologically, this disorder is often responsive to immunosuppressant treatment. We here in report the case of a 56-year-old man with anti NMDA-R encephalitis presenting initially with disorientation and hallucination. He later developed bilateral ophthalmoplegia and spastic tetraparesis. Neurological examination showed mild consciousness disturbance and bilateral ophthalmoplegia on admission, spastic tetraparesis with limbs hyperreflexia. Cerebrospinal fluid samples showed mild pleocytosis. MRI disclosed some small hypersignal lesions in the FLAIR. Anti-NMDA-R antibody was diagnosed upon detection of antibody in the serum. Psychiatrists and neurologists should pay more attention to the cranial, mental and behavioral involvement due to this potentially fatal disease.