Experience with anti NMDA receptor antibody encephalitis in a tertiary care hospital in Pakistan

Abstract

Background and objective: 
 Anti NMDA receptor (Anti-NMDAR) antibody encephalitis is an increasingly recognized form of auto immune encephalitis. The objective of this study was to determine the demographic, clinical and laboratory factors associated with this syndrome. 
 Methods:
 All cases presenting to neurology, Pakistan institute of medical sciences, Islamabad, from June 2017 till January 2020 were reviewed retrospectively. Patients fulfilling the diagnostic criteria for Anti NMDA receptor (Anti-NMDAR) antibody encephalitis were included. All patients were evaluated with cerebrospinal fluid (CSF)routine examination, MRI brain, autoimmune encephalitis profile and for presence of oligoclonal bands (OCB) in CSF. Statistical analysis was done using SPSS version 23.0.
 Results:
 A total of 7 patients were diagnosed as having Anti-NMDARantibody encephalitis. Five patients were female and two were male. Four patients had some type of psychiatric disturbances upon presentation of these behavioral abnormalities and irritability were found in all four. Orofacial abnormal movements were found in four patients while one patient had myoclonic seizures.
 Conclusion:
 Anti-NMDARreceptor encephalitis is a common cause of encephalitis associated with neurological and psychiatric symptoms. Delay in diagnosis can occur due to non-specific symptoms and signs present in early stages of illness,this can lead to long term neurological disability.