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Anti-NMDA-receptor encephalitis: case report and literature review of an under-recognized condition.
J Gen Intern Med. 2011 Jul; 26(7):811-6.JG

Abstract

Anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis is an immune-mediated syndrome that remains under-recognized despite a growing body of literature. This syndrome has been predominantly described in young females with a constellation of symptoms, including personality changes, autonomic dysfunction and neurologic decompensation. It is commonly associated with mature ovarian teratomas. We describe the classic presentation of anti-NMDA-R encephalitis in three dramatically different patients: Case A, a young woman with ovarian teratoma; Case B, the eldest case reported to date; and Case C, a young male with no identifiable tumor. We review the literature summarizing the differential diagnosis, investigative approach, treatment options and challenges inherent to this disorder. We advocate good supportive care, involvement of multiple health disciplines and use of immune-modulating therapies in patient management. These cases underscore the need for increased awareness and high diagnostic suspicion when approaching the patient with suspected viral encephalitis.

Authors+Show Affiliations

Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada. gregg.day@utoronto.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

21318640

Citation

Day, Gregory S., et al. "Anti-NMDA-receptor Encephalitis: Case Report and Literature Review of an Under-recognized Condition." Journal of General Internal Medicine, vol. 26, no. 7, 2011, pp. 811-6.
Day GS, High SM, Cot B, et al. Anti-NMDA-receptor encephalitis: case report and literature review of an under-recognized condition. J Gen Intern Med. 2011;26(7):811-6.
Day, G. S., High, S. M., Cot, B., & Tang-Wai, D. F. (2011). Anti-NMDA-receptor encephalitis: case report and literature review of an under-recognized condition. Journal of General Internal Medicine, 26(7), 811-6. https://doi.org/10.1007/s11606-011-1641-9
Day GS, et al. Anti-NMDA-receptor Encephalitis: Case Report and Literature Review of an Under-recognized Condition. J Gen Intern Med. 2011;26(7):811-6. PubMed PMID: 21318640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anti-NMDA-receptor encephalitis: case report and literature review of an under-recognized condition. AU - Day,Gregory S, AU - High,Sasha M, AU - Cot,Bianca, AU - Tang-Wai,David F, Y1 - 2011/02/12/ PY - 2010/10/29/received PY - 2011/01/13/accepted PY - 2010/12/29/revised PY - 2011/2/15/entrez PY - 2011/2/15/pubmed PY - 2011/10/7/medline SP - 811 EP - 6 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 26 IS - 7 N2 - Anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis is an immune-mediated syndrome that remains under-recognized despite a growing body of literature. This syndrome has been predominantly described in young females with a constellation of symptoms, including personality changes, autonomic dysfunction and neurologic decompensation. It is commonly associated with mature ovarian teratomas. We describe the classic presentation of anti-NMDA-R encephalitis in three dramatically different patients: Case A, a young woman with ovarian teratoma; Case B, the eldest case reported to date; and Case C, a young male with no identifiable tumor. We review the literature summarizing the differential diagnosis, investigative approach, treatment options and challenges inherent to this disorder. We advocate good supportive care, involvement of multiple health disciplines and use of immune-modulating therapies in patient management. These cases underscore the need for increased awareness and high diagnostic suspicion when approaching the patient with suspected viral encephalitis. SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/21318640/Anti_NMDA_receptor_encephalitis:_case_report_and_literature_review_of_an_under_recognized_condition_ L2 - https://dx.doi.org/10.1007/s11606-011-1641-9 DB - PRIME DP - Unbound Medicine ER -