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Anti-N-methyl-D-aspartate receptor encephalitis

Evidence: Antibody

Names

Anti-N-methyl-D-aspartate receptor encephalitis Anti-NMDA receptor encephalitis

Description

Anti-NMDA receptor encephalitis is an autoimmune disorder in which the body attacks the brain’s NMDA receptors. N-Methyl-D-Aspartate (NMDA) receptors are proteins that play a significant role in learning and memory.

When the NMDA receptor antibodies attack the NMDA receptors in the brain, certain functions of the brain are disrupted and brain swelling, or encephalitis, occurs. At disease onset, patients often have symptoms consistent with those caused by a virus.  Within 3 months of onset, patients develop psychological or neurological problems, including seizures and perceptual and behavioral changes.  As the disorder progresses, patients become verbally unresponsive and experience difficulty with movement.  With time, problems with regulation of autonomic processes, such as heart rate and breathing, emerge.  Some cases of this disease have been associated with tumors, especially of the ovary. In severe cases, complications can result in relapse, chronic cognitive problems, or death.  However, if treatment and medical supervision is received, most patients can expect to fully recover.

Prevalence

US Incidence: Approximately 200 cases per year (1 per 1.5 million people per year) [Samanta 2020]. Females are 4 times more likely to be affected than men.

Typical Age of onset

Possible between 2 months and 85 years of age.  Most common in women between 25 and 35 years old [Samanta 2020]

Symptoms

  • Flu-like symptoms

  • Sleep disorders

  • Hallucinations

  • Depression

  • Mania Eating disorders (sudden onset)

  • Anxiety Apathy

  • Unusual behaviors

  • Memory problems

  • Seizures

  • Verbal unresponsiveness (mutism)

  • Irregular heartbeat (arrythmia)

  • Difficulty breathing

  • Body temperature fluctuation

  • Blood pressure fluctuation

  • Loss of Consciousness

  • Rhythmic motion of arms

  • Rhythmic motions of legs

  • Abnormal facial movements

  • Tremors

  • Shakes

  • Feet and hands “fall asleep”