Anti-NMDA Receptor Encephalitis: Four Case Reports and Literature Review

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, immunotherapyAddress Correspondence to author:Kongkiat Kulkantrakorn, M.D. Neurology Division, Department of Internal Medicine Faculty of Medicine, Thammasat University Pathumthani 12120, Thailand email: kongkiat1@gmail.comReceived: June 22, 2018Revision received: June 22, 2018Accepted after revision: July 2, 2018BKK Med J 2018;14(2): 66-71.DOI: 10.31524/bkkmedj.2018.09.012