# Anti-N-Methyl-D-Aspartate Receptor Encephalopathy in a Young Female

## TL;DR

A young woman with no prior health issues developed a rare brain condition caused by antibodies attacking NMDARs, leading to psychiatric and neurological symptoms that resolved after treatment.

## Contribution

This case highlights the presentation and successful treatment of anti-NMDAR encephalopathy in a young female with no prior medical history.

## Key findings

- The patient exhibited acute psychiatric and neurological symptoms consistent with anti-NMDAR encephalopathy.
- Diagnosis was confirmed through clinical evaluation and laboratory imaging.
- Symptoms resolved completely after targeted treatment over two months.

## Abstract

Widely distributed in the central nervous system (CNS), N-methyl-D-aspartate receptors (NMDARs) are believed to be involved in long-term potentiation, essential in regulating and forming memory. This condition primarily occurs in young females because of autoantibodies forming against the N-methyl-D-aspartate receptor-1 (NR1) or N-methyl-D-aspartate receptor-2 (NR2) subunits of NMDAR in the CNS, ultimately portraying a unique psychoneurological phenomenon. Patients with antibodies against NMDAR present with a combination of neurological and psychiatric signs and symptoms. This article presents a case of a young female with no significant past medical, psychological, or surgical history. While being previously diagnosed with acute psychosis, upon arrival at the emergency department (ED), she also displayed an acute decline in judgment, hallucinations, severe agitation, and peculiar behavior, prompting family members to seek medical attention. Consequently, she was evaluated for metabolic and infectious encephalopathy. Following a thorough examination and extensive laboratory imaging, the patient was found to have NMDAR antibody encephalopathy. After dedicated treatment, her two-month follow-up presented a complete resolution of symptoms.