Anti-N-methyl-D-aspartate receptor encephalitis: a new autoimmune encephalitis

Abstract

Anti-N-methyl-D-aspartate (anti-NMDA ) receptor encephalitis is a new category of treatable encephalitis associated with anti-NMDA receptor antibody, which attracts more and more attention recently. It is clinically characterized by prodromal fever, schizophrenia-like psychiatric symptoms, seizures, disturbance of consciousness, dyskinesia (particularly orofacial), and autonomic dysfunction, which often occur in young females with ovarian teratomas. Autoantibodies to the anti-NMDA receptor in serum and cerebrospinal fluid are positive. Electroencephalogram (EEG) often reveals diffuse δ slowing without paroxysmal discharges, on which " δ rush" is considered as specific characteristic in some patients. Combined therapy including tumor resection and immunotherapy is recommended. The updates in mechanisms, clinical manifestations and diagnostic examinations associated with anti-NMDA receptor encephalitis will be discussed in this review.