Autoimmune anti-N-methyl-D-aspartate (NMDA)-receptor encephalitis as a rare cause of complex psychiatric and neurologic manifestations. Case report and literature review

Abstract

Anti-N-methyl-D-aspartate (NMDA)-receptor encephalitis is an rare autoimmune disease associated with antibodies against of the NMDA receptors in the central nervous system. In more than half of patients, the disease coexists with ovarian teratoma. Most patients develop a multistage illness that progresses from psychosis, cognitive dysfunction, and seizures, into a state of unresponsiveness with catatonic features often associated with a movement disorder, autonomic instability, and central hypoventilation. The work presents a case of a 20-year-old female who was transferred to an intensive care unit from the Department of Psychiatry, due to a worsening state of consciousness with symptoms of respiratory failure and hemodynamic instability. In the previous clinic, the patient was treated for catatonic schizophrenia, with no results. The diagnosis of autoimmune encephalitis was made on the basis of the result of cerebrospinal fluid, in which antibodies to NMDA receptors were detected.

Keywords

• respiratory insufficiency
• catatonic schizophrenia
• anti-nmda receptor encephalitis