Anti-NMDAR encephalitis for psychiatrists: the essentials

Beattie, M., Goodfellow, J., Oto, M. and Krishnadas, R. (2022) Anti-NMDAR encephalitis for psychiatrists: the essentials. BJPsych Bulletin, 46(4), pp. 235-241. (doi: 10.1192/bjb.2021.35) (PMID:34075874) (PMCID:PMC9768510)

[img] Text
266709.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

743kB

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis predominantly presents with psychiatric symptoms. Psychiatrists need to be alert to this diagnostic possibility, especially in female adolescents and young adults, as exemplified by the real (de-identified) case outlined below. Earlier diagnosis and immunotherapy improves long-term outcomes. Collaboration with neurology colleagues is essential for optimal care. ‘Red flags’ for autoimmune encephalitis and ‘diagnostic clues’ act as helpful aide memoires for this uncommon condition. The gold standard for testing is the detection of NMDAR antibodies in cerebrospinal fluid, but serum can be tested as a more accessible (but less reliable) preliminary step. The results of routine blood tests, magnetic resonance imaging of the head and electroencephalograms can be normal or show non-specific changes. Diagnostic criteria exist to define probable and definite cases. Immunotherapy for anti-NMDAR encephalitis is effective for many patients, but recovery is prolonged and relapses can occur.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Goodfellow, Mr John and Beattie, Dr Matthew and Krishnadas, Dr Rajeev
Authors: Beattie, M., Goodfellow, J., Oto, M., and Krishnadas, R.
College/School:College of Medical Veterinary and Life Sciences > School of Infection & Immunity
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
Journal Name:BJPsych Bulletin
Publisher:Cambridge University Press
ISSN:2056-4694
ISSN (Online):2056-4708
Published Online:02 June 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in BJPsych Bulletin 46(4): 235-241
Publisher Policy:Reproduced under a Creative Commons License

University Staff: Request a correction | Enlighten Editors: Update this record