Anti-NMDA receptor encephalitis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Historical Perspective
Anti-NMDA encephalitis, initially documented in a case report dating back to 1830, is an autoimmune condition marked by neuropsychiatric manifestations. In some instances, the presence of an ovarian teratoma is observed. The case of Susannah Cahalan played a significant role in raising public awareness regarding this disorder.
Classification
Anti-NMDA encephalitis can be categorized into three distinct subtypes based on the timing of onset and duration of the illness.
Pathophysiology
Anti-NMDA receptor encephalitis is an autoimmune disorder characterized by the presence of autoantibodies directed against the GluN1 subunit of the NMDA receptor. The presence of tumors, particularly ovarian teratomas in women and testicular teratomas or lung carcinomas in men, is frequently associated with the condition. Dysregulation of NMDA receptors contributes to the development of diverse neurological and psychiatric symptoms.
Causes
In anti-NMDA receptor encephalitis, autoantibodies targeting the GluN1 subunit of the NMDA receptor are present. These antibodies lead to internalization of NMDA receptors, disrupting synaptic plasticity and causing a range of neurological and psychiatric symptoms. Various causes of the antibodies include , infections, vaccinations and tumors
Differentiating Anti-NMDA receptor encephalitis from other Diseases
In the differential diagnosis of anti-NMDA encephalitis, other autoimmune encephalitides with specific antibody associations should be considered, including those associated with antibodies against AMPA receptors, GABA-B receptors, LGI1, Caspr2, and MOG. Clinical and serological evaluations are crucial for accurate diagnosis and appropriate management.