Anti-NMDA Receptor Encephalitis Initially Misdiagnosed as Psychiatric Illness: Implications for Perioperative and Critical Care Management
Hadeel Abuatiyeh (1) • Mina Sarmad Alhashemi(2) • Selina AlSrour(3) • Raghad Radi(4) • Baker Shiha(5)
Published in Academic Anesthesia Journal :doi.org/10.62186/XTTU2353
Google Scholar Index: article/145182
Abstract
Background
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a rare autoimmune disorder that may initially present with psychiatric symptoms, making its early recognition challenging.
Case report
We report a 24-year-old female presenting with acute psychosis, behavioral changes, and insomnia, initially treated as a primary psychiatric disorder. She later developed seizures, orofacial dyskinesia, and autonomic dysfunction. CSF analysis revealed strongly positive anti-NMDA receptor antibodies, and pelvic imaging identified a left ovarian teratoma. The tumor was surgically removed and followed by immunotherapy with corticosteroids and IVIG. She achieved complete recovery within six months.
Conclusion
Anti-NMDA receptor encephalitis is a rare but treatable diagnosis that clinicians should consider in young patients with atypical or rapidly progressive psychiatric symptoms. Early recognition leads to the early course of tumor removal and the initiation of immunotherapy, providing optimal outcomes.