Anti-NMDA receptor encephalitis

Anti-NMDA receptor encephalitis is an autoimmune neurological disorder characterized by inflammation of the brain (encephalitis) that results from the production of antibodies against NMDA (N-methyl-D-aspartate) receptors, which are critical for memory function and cognition.

NR1-NR2B subunit

Extreme delta brush in anti-NMDAr encephalitis

Pathophysiology

The disease process involves the generation of autoantibodies that target NMDA receptors in the brain. These antibodies disrupt normal neurological processes by altering the functioning of these receptors, leading to the array of neurological and psychiatric symptoms seen in the condition.

Clinical Presentation

The onset of Anti-NMDA receptor encephalitis is usually subtle, beginning with non-specific symptoms such as fever, headache, and fatigue. As the disease progresses, patients often exhibit psychiatric symptoms, which may include delusions, hallucinations, and agitation. Cognitive impairment and confusion are also common.

Over time, the disease may lead to severe neurological issues such as seizures. Autonomic instability can also occur, leading to fluctuations in heart rate, blood pressure, and respiratory rate. This disorder may progress rapidly and may lead to respiratory failure, requiring mechanical ventilation in severe cases.

Diagnosis and Treatment

Diagnosis involves the detection of anti-NMDA receptor antibodies in the cerebrospinal fluid (CSF). Brain imaging and electroencephalography (EEG) may also be utilized to exclude other potential causes of encephalitis.

Treatment involves the removal of antibodies, often through immunosuppressive therapies, plasmapheresis, or intravenous immunoglobulin (IVIG). Early detection and treatment of the condition can significantly improve prognosis.

References

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See Also

• NMDA receptor
• Encephalitis
• Autoimmune diseases

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