Electronic ISSN 2287-0237

VOLUME

ANTI-NMDA RECEPTOR ENCEPHALITIS: FOUR CASE REPORTS AND LITERATURE REVIEW

SEPTEMBER 2018 - VOL.14 | CASE REPORT

tract Anti-NMDA receptor encephalitis is increasingly being recognized as one of the causes of non-infectious encephalitis. Here, we report four female patients with this disease who had a different clinical course and outcome. The patients are all female aged below 45 years old, especially teenagers, and it is usually accompanied by ovarian teratoma. The disease often starts with a prodromal phase of flu-like symptoms, followed by progression into major typical symptoms: prominent psychiatric disorder or bizarre behavior, seizure, abnormal movement, dysfunctional speech, memory deficit, alteration of consciousness and autonomic instability. Recognizing this syndrome and confirming with antibody testing will more likely lead to a favorable outcome. Prompt immunotherapy should be initiated, common protocols are high doses of steroids, plasmapheresis and intravenous immunoglobulin. However, the treatment protocol and long-term management is still not established.

Keywords:

Anti-NMDA receptor encephalitis, immunotherapy

Address Correspondence to author:

Kongkiat Kulkantrakorn, M.D. Neurology Division, Department of Internal Medicine Faculty of Medicine, Thammasat University Pathumthani 12120, Thailand email: kongkiat1@gmail.com

Received: June 22, 2018

Revision received: June 22, 2018

Accepted after revision: July 2, 2018

BKK Med J 2018;14(2): 66-71.

DOI: 10.31524/bkkmedj.2018.09.012

MEDIA
Figure 1: Electroencephalogram (EEG) of case 1 revealed generalized extreme delta brush without epileptic activity (arrow).
Figure 2: Ovarian cyst; Histological sections of ovarian cyst are composed of three layers of tissue component including skin with appendages, brain, adipose tissue and respiratory typed mucosa with cartilage. Patchy lymphoid aggregates are also seen.
Table 1: Diagnostic criteria for anti-NMDA receptor encephalitis.
Table 2: Summary of four cases
SEARCH VOLUME & NUMBER
GO
RECENT VOLUME & NUMBER