[Differential diagnosis of encephalitis due to anti-NMDA receptor antibodies]. / Diagnóstico diferencial en la encefalitis por anticuerpos contra el receptor NMDA.

ABSTRACT

INTRODUCTION: Anti-NMDA receptor (NMDAR) encephalitis usually develops as a multistage syndrome with a broad differential diagnosis. PATIENTS We report 2 patients with anti-NMDAR encephalitis and a clinical picture typical of this disorder but whose initial evaluation suggested other aetiologies. DISCUSSION: The frequent development of this disorder in young individuals presenting with psychiatric manifestations often suggests other diagnostic possibilities, most commonly viral encephalitis, psychiatric disorders, and neuroleptic malignant syndrome. In addition, several less clearly defined syndromes or descriptively reported disorders in adult and paediatric patients were likely cases of anti-NMDAR encephalitis. CONCLUSIONS: Anti-NMDAR encephalitis should be considered in young individuals with subacute presentation of psychiatric symptoms, abnormal movements, and autonomic dysfunction. The clinical and immunological characterization of this disorder has lead to the identification of new antibodies that affect memory, learning, behaviour and psychosis.