Review Article

Anti-N-Methyl-D-aspartate Receptor Encephalitis: A Severe, Potentially Reversible Autoimmune Encephalitis

Table 1

Clinical features of anti-NMDAR encephalitis in adults and children.

AdultsChildren
Antecedent infection (0–2 weeks)More than 80% of patients; fever, headache, digestive-tract or upper respiratory-tract symptomsLess common
Psychiatric and behavioral symptomsAbout 80% of the cases; anxiety, irritability, insomnia, paranoia, aggression, auditory or visual hallucinations, sexual disinhibition, mania, cognitive disorder and psychosis; isolated psychiatric symptoms are rareLess common
SeizuresAbout 70% of the cases; usually partial in males, and generalized in females; prolonged status epilepticus may occurUsually partial motor or complex seizures; initially as frequently as psychiatric symptoms
Motor dysfunctionsOrofacial dyskinesias, chorea, ballismus, athetosis, rigidity, stereotyped movements, myorhythmia, or opisthotonusMore common; atypical symptoms such as hemiparesis or cerebellar ataxia predominate in this age group
Memory dysfunctionShort-term memory lossLess common
Speech disordersMore than 70% of patients; reduction of verbal output or mutism, echolalia (usually with echopraxia), mumbling, or perseveration
Decrease in level
of consciousness
88% of patients during the first 3 weeks
Autonomic dysfunctionsAbout 70% of the cases; hyperthermia, cardiac dysrhythmias (tachycardia or bradycardia), hypersalivation, hypotension, hypertension, urinary incontinence, and sexual dysfunctionMore common; predominantly tachycardia, hyperthermia, and hypertension
Central hypoventilationApproximately 70% of patientsLess common