Abstract:
Objective To investigate the clinical diagnostic features and treatment approaches of anti-N-methy-D-aspartate (NMDA) receptor encephalitis with initial presentation of mental and behavioral symptoms.
Methods A retrospective analysis was conducted on the medical records of a patient with anti-NMDA receptor encephalitis with initial presentation of mental and behavioral symptoms who was admitted to the Department of Child Psychology and Behavior of Linyi Municipal Mental Health Center on July 24, 2024. The clinical characteristics, diagnosis and treatment were analyzed, and relevant literature was reviewed.
Results A 16-year-old female patient first visited the Department of Psychiatry due to behavioral and speech disorders for 4 days. She was diagnosed with " acute and transient psychotic disorder" . After treatment with antipsychotic drugs, her mental symptoms were still progressively worsen, with the symptoms of fever, confusion, and paroxysmal involuntary convulsions of the mouth, face and limbs developing. The tests for anti-glutamate receptor (NMDA type) antibodies in her serum and cerebrospinal fluid were both positive. The final diagnosis was anti-NMDA receptor encephalitis.
Conclusions The misdiagnosis rate of anti-NMDA receptor encephalitis with initial presentation of mental and behavioral symptoms is extremely high. Clinicians should enhance their understanding of this disease to avoid misdiagnosis and missed diagnosis, so as to guide treatment and improve prognosis.
Key words:
Anti-N-methyl-D-aspartate receptor encephalitis,
Psychiatric symptom,
Abnormal behavior symptom,
Diagnosis,
Immunotherapy
Zhenxiao Sun, Xiumin Ge, Xiangfen Yu. A case of anti-N-methyl-D-aspartate receptor encephalitis with initial presentation of mental and behavioral symptoms and literature review[J]. Chinese Journal of Diagnostics(Electronic Edition), 2025, 13(04): 280-283.