A rapidly progressive case of anti-NMDAR encephalitis with primarypsychiatric symptoms

Abstract

Since the introduction by Dalmau et al in 2007, numbers of reported anti-NMDAR encephalitis cases have increased with the growing interest of professionals in the diagnosis of this neurological condition (Dalmau et al. 2007). Although it was initially thought to be a rare phenomenon, more than 700 patients have been reported so far (Warren et al. 2018). The majority of the anti-NMDAR encephalitis cases are first seen by psychiatrists due to acute or subacute manifestations of psychiatric symptoms (Kayser & Dalmau 2011a). Agitation, bizarre, and disinhibited behaviors, delusions, and hallucinations are the most commonly reported symptoms in these patients (Barry et al. 2015). Approximately 75% of the patients fully recover or have mild deficits in the long-term, while 25% remain severely disabled; and the anti-NMDAR encephalitis mortality rate is estimated to be around 4% (Warren et al. 2018). In this report, we aimed to present a rapidly progressing case of anti-NMDAR encephalitis with early psychiatric symptoms.