Anti NMDA encephalitis presenting with mixed psychiatric symptoms - case report


  • Swathy Sheela Sudevan Junior Resident in Psychiatry, Government Medical College, Kozhikode
  • Gayatri Rajan Junior Resident in Psychiatry, Government Medical College, Kozhikode
  • Arathi J S Senior Resident in Psychiatry, Government Medical College, Kozhikode
  • Varsha Vidyadharan Assistant Professor in Psychiatry, Government Medical College, Kozhikode
  • Harish M Tharayil Professor of Psychiatry, Government Medical College, Kozhikode



antinmda encephalitis, psychiatric manifestation, limbic encephalitis


Anti NMDA receptor encephalitis is an autoimmune reaction against neuronal cell surface antigens. The prevalence of this condition is about 0.6 per lakh. Here, we present the case of an 18-year-old female, who presented with seizures along with both dissociative and psychotic symptoms. Later, she turned out to be a case of Anti-NMDA receptor encephalitis. Anti NMDA receptor encephalitis presents with behavioural, cognitive, psychiatric and neurological symptoms progressing to coma and death if untreated. The patient did not show improvement with first-line therapy like IVIG. Hence, the second-line agent, Rituximab, had to be used. She needed three anti-epileptic drugs for seizure control. There is evidence that delay in treatment can adversely affect the prognosis. There should be increased awareness among psychiatrists and other relevant medical professionals about this under-diagnosed disorder.



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How to Cite

Sudevan, S. S., Rajan, G., J S, A., Vidyadharan, V., & Tharayil, H. M. (2020). Anti NMDA encephalitis presenting with mixed psychiatric symptoms - case report. Kerala Journal of Psychiatry, 33(1), 56–59.



Case Report