Anti-NMDA receptor encephalitis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] AE Dheeraj Makkar, M.D.[2]

Physical Examination

Common physical examination findings of Anti-NMDA encephalitis include:

• Systemic and neurological symptoms lack specificity. The clinical examination does not reveal any indicators of anti-NMDAR encephalitis.Patients exhibit symptoms of widespread encephalopathy, suggesting neurologic impairment of subcortical, limbic, and frontostriatal circuitry. Some features of neurological disorders include
  • orofacial dysostosis, dyskinesis, choreoathetosis, dystonia, oculogyric crises, stiffness, pelvic thrusting and opisthotonic posture.
• Multiple altered states of consciousness are possible. Infrequently, signs of elevated intracranial pressure may be observed in the aftermath of protracted status epilepticus.

• In addition to mobility difficulties, a neurologic examination may reveal nonspecific symptoms of diffuse cerebral dysfunction, such as increased deep tendon reflexes, extensor plantar responses, and tone abnormalities.

• Soft neurologic symptoms, including mild ataxia and difficulty with fine motor coordination, may also be present.

• • tachycardia and hypertension, are signs of autonomic storming in patients.