Anti NMDA encephalitis presenting with mixed psychiatric symptoms -  case report

Swathy Sheela Sudevan; Gayatri Rajan; Arathi J S; Varsha Vidyadharan; Harish M Tharayil

doi:10.30834/KJP.33.1.2020.190

Authors

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

DOI:

https://doi.org/10.30834/KJP.33.1.2020.190

Keywords:

antinmda encephalitis, psychiatric manifestation, limbic encephalitis

Abstract

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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