Anti-NMDA Receptor Encephalitis: A Rare but Important Auto-Immune Cause of Encephalitis

Authors

Muhammad Sohail Ajmal Ghoauri Department of Neurology, Bahawal Victoria Hospital, Quaid-e-Azam Medical College, Bahawalpur Pakistan.
Nauman Ismat Butt Department of Medicine & Allied, Azra Naheed Medial College, Superior University, Lahore Pakistan.
Muhammad Umair Javed Department of Pulmonology, Bahawal Victoria Hospital, Quaid-e-Azam Medical College, Bahawalpur Pakistan.
Muhammad Bilal Rasheed Department of Medicine & Allied, Azra Naheed Medial College, Superior University, Lahore Pakistan.
Shoaib Luqman Department of Neurology, Bahawal Victoria Hospital, Quaid-e-Azam Medical College, Bahawalpur Pakistan.
Sabir Ali Department of Neurology, Bahawal Victoria Hospital, Quaid-e-Azam Medical College, Bahawalpur Pakistan.

Anti-NMDA receptor encephalitis, Anti-NMDA receptor antibodies, Plasma exchange, Antibiotic therapy, Meningeal, Autoimmune

Abstract: A previously healthy 30-year old lady presented with 1-day history of high grade fever and drowsiness. Five days prior to

presentation, she developed insomnia and visual hallucinations of seeing unknown faces. Three days prior to presentation, she suffered from 5

episodes of generalized tonic colonic fits. On admission, she had a temperature of 102oF and GCS of 10/15 with no signs of meningeal

irritation, no focal neurological deficit, normal deep tendon reflexes and down-going plantar reflex bilaterally. Her brain MRI scan showed

mild hyper-intense signals in right cerebellum. Her CSF was tested for Anti-NMDA receptor antibodies which were positive. She was

diagnosed as having Anti-NMDA Receptor Encephalitis and started on immediate Plasma Exchange with drastic improvement.