Catatonia secondary to anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis: a review

CNS Spectr. 2020 Aug;25(4):475-492. doi: 10.1017/S1092852919001573. Epub 2019 Oct 30.


Anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis is a relatively recent autoimmune entity, as it was first described in 2007. Given that it is a condition with neuropsychiatric symptoms, its initial symptom is frequently psychiatric in nature. Hence, psychiatrists are often the first physicians to assess these patients and, as so, must recognize this type of encephalitis as a possible cause. Catatonia may be inaugural or develop throughout the course of the disease. Management of patients with anti-NMDAr encephalitis is based on etiologic treatment with immunotherapy and removal of the associated tumor, if any. However, these catatonic patients may have variable responses to etiologic treatment, sometimes with refractory catatonic symptoms, which attests to the necessary urgency to know how to manage these patients. In the clinical setting, physicians appear to be using guidelines originally created to the management of catatonia due to primary psychiatric conditions. In this literature review, catatonia was historically contextualized and anti-NMDAr encephalitis overall described. Finally, catatonia secondary to this type of encephalitis was discussed.

Keywords: Catatonia; anti-N-methyl-D-aspartate receptor encephalitis; anti-NMDAr encephalitis; neuropsychiatry.

Publication types

  • Review

MeSH terms

  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / complications*
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnosis
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / therapy
  • Catatonia / diagnosis
  • Catatonia / etiology*
  • Catatonia / therapy
  • Humans