A Case of New Onset Psychosis in a Young Woman with Minimal Response to Risperidone, Ultimately Diagnosed with N-Methyl-D-Aspartate Receptor Encephalitis: A Review of this Under-Recognized Condition

Clin Schizophr Relat Psychoses. Fall 2015;9(3):135-40. doi: 10.3371/CSRP.SPZA.061213. Epub 2013 Jun 17.

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe, treatable and potentially reversible disorder presenting with memory deficits, psychiatric symptoms and seizures. Initially described in young patients with ovarian teratoma, the disease is meanwhile increasingly recognized also in women without tumors, in men and in children. The presence of anti-glutamate receptor (type NMDA) autoantibodies in serum or cerebrospinal fluid is specific for this novel and widely under-diagnosed disorder. We present a young women presenting with psychotic symptoms, initially treated psychiatrically, but was ultimately discovered to have anti-NMDAR encephalitis. We review this disease state with respect to epidemiology, phenomenology, pathogenesis, and treatment.

Keywords: Anti-N-Methyl-D-Aspartate Receptor Encephalitis; Psychosis; Teratoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis*
  • Antipsychotic Agents / therapeutic use
  • Female
  • Humans
  • Psychotic Disorders / drug therapy
  • Psychotic Disorders / etiology*
  • Risperidone / therapeutic use

Substances

  • Antipsychotic Agents
  • Risperidone