# A Case Report of Anti-N-Methyl-D-Aspartate Receptor (NMDAR) Encephalitis

## TL;DR

This paper reports a case of anti-NMDAR encephalitis in a 30-year-old woman, highlighting the importance of early diagnosis for better outcomes.

## Contribution

The paper contributes a detailed clinical case emphasizing the need to consider anti-NMDAR encephalitis in psychiatric differential diagnoses.

## Key findings

- The patient exhibited sudden-onset psychiatric symptoms resembling schizophrenia, which were later diagnosed as anti-NMDAR encephalitis.
- Early diagnosis and treatment are critical to reducing long-term complications and recurrence risks.
- The case highlights the association between anti-NMDAR encephalitis and the presence of anti-GluN1 antibodies in CSF.

## Abstract

Anti-N-methyl-D-aspartate (NMDA) receptor (NMDAR) encephalitis is a relatively recent condition, classified as an immune-mediated disorder characterized by a complex neuropsychiatric syndrome and the presence of anti-GluN1 subunit antibodies against the NMDA receptor in cerebrospinal fluid (CSF). Although it is a rare disease, studies have identified it as one of the most common causes of autoimmune encephalitis. The pathophysiology of this condition is not yet fully understood, especially regarding its association with ovarian teratomas and other neoplasms. We present the case of a 30-year-old woman, previously healthy and independent, who developed a sudden onset of psychosis, marked emotional lability, disorganized speech, and agitation. Subsequently, she experienced severe sleep deprivation accompanied by grandiose delusions and auditory hallucinations. Due to the fluctuating nature of her symptoms and their progressive worsening, the patient required prolonged hospitalization, including admissions to intermediate and intensive care units, and underwent extensive diagnostic testing before a definitive diagnosis was made. Early diagnosis of anti-NMDAR encephalitis is crucial, as prompt and appropriate treatment can significantly reduce long-term sequelae and the risk of recurrence. This case underscores the importance of considering anti-NMDAR encephalitis in the differential diagnosis of new-onset psychiatric disorders, especially those resembling schizophrenia.