Retrospective Analysis of Anti-N-methyl-D-aspartate Receptor Encephalitis
LIU Jia-fu
YU Yang
WANG Shu-yun
CHEN Xiang-jun
PAN Shu-ming
Abstract：Objective To summarize the early diagnosis points of anti-N-methyl-D-aspartate (NMDA) receptor en-cephalitis, in order to reduce the misdiagnosis rate. Methods Clinical data of a misdiagnosed female patient with NMDA re-ceptor encephalitis was retrospectively analyzed. Results The patient had a history of fever for more than 20 days, and pro-gressive mental disorder for 9 days, and was diagnosed as having respiratory tract infection and schizophrenia. She was admit-ted to our hospital without improvement after treatment by other hospitals. The patient had a lower SpO2 , PCT 0. 04 ng/ml, CRP 19 mg/L, normal routine cerebrospinal fluid tests. Central hypoventilation was indicated. New symptoms appeared, in-cluding hypersalivation, occasional lip licking, tongue protrusion. Video-Electroencephalography ( EEG) demonstrated abnor-mal diffuse low-voltage slow-activities. She had an ovarian teratoma. NMDA receptor encephalitis was highly suspected. Posi-tive anti-NMDA receptor antibody in her cerebral spinal fluid and serum confirmed the diagnosis. Intravenous immunoglobulin treatment and methylprednisolone plus teratoma resection were performed. The patient recovered later. Conclusion We should have a high suspicion for anti-NMDA receptor encephalitis in young patients with abrupt mental status changes with conscious and movement disorder, especially with ovarian teratoma. The NMDA receptor encephalitis diagnosis should be based on test of anti-NMDA receptor antibody in order to confirm the diagnosis.
Keywords：N-methyl-D-aspartateAnti-N-methyl-D-aspartate receptor encephalitisOvarian teratomaMisdianosisSchizophrenia
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 13-16 )