Anti-NMDA Receptor Encephalitis
We are, in the end, a sum of our parts, and when the body fails, all the virtues we hold dear go with it – Brain on Fire, Susannah Cahalan
image by: The Anti-NMDA Receptor Encephalitis Foundation, Inc
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Anti-NMDA Receptor Encephalitis - An Inside Look
Sheila was driving everyone crazy. Sheila was loud, excitable, erratic, and messy. Really messy. More importantly, her wild behavior was starting to affect the whole neighborhood. And everyone used to get along so well. They dreamed together. They created great art together. They did math homework together. They had wonderful planning sessions together. They were a well organized group of high functioning neurons committed to helping the brain function efficiently and effortlessly. But not anymore. Now their area was filled with excess metabolites floating around a group of tired and overworked neurons.
“This is all Sheila’s fault. Her crazy behavior is ruining the whole neighborhood,”…
Resources
A Catastrophic Diagnosis You Probably Don't Know
Anti-NMDAR encephalitis, first described in 2007, causes devastating, progressive neurologic and cognitive deterioration, ending with catatonia and sometimes death. The diagnosis is often delayed or not suspected at all because many physicians do not know of it. Patients will often respond dramatically — even completely — to specific immunotherapy, so missing the diagnosis can be catastrophic.
The Hard Reality of Living with M.E. aka Chronic Fatigue Syndrome
M.E. doesn't just mean "being tired all the time" – the brain can't connect properly to the spinal nerve tracts and so fails to control vital bodily functions. It's time we started taking it seriously.
Treatable Immune System Disorder Could Be Mistaken For Schizophrenia or Bipolar Disorder
Researchers at Houston Methodist believe that a significant number of people diagnosed with schizophrenia or bipolar disorder may actually have a treatable immune system condition. A new research study could have a significant impact on the millions diagnosed with schizophrenia or bipolar disorder, including many homeless.
A case report: anti-NMDA receptor encephalitis
N-methyl-d-aspartate receptor (NMDAR) antibody encephalitis is a potentially fatal autoimmune syndrome in which there is antibody production against the NMDAR causing profound dysregulation of neurotransmission. The syndrome is frequently associated with ovarian teratomas and women are disproportionately affected. Patients most often present with a constellation of neuropsychiatric signs and symptoms, including memory loss, hallucinations, and decreased level of consciousness. This condition is lethal if left untreated. Immunotherapy and surgical resection of the culprit malignancy often results in the rapid resolution of symptoms.
A Multidisciplinary Approach to the Treatment of Anti-NMDA-Receptor Antibody Encephalitis: A Case and Review of the Literature
Anti-NMDAR (N-methyl-d-aspartate receptor) encephalitis is a novel autoimmune and paraneoplastic disease often presenting as acute psychosis. Few studies exist in the psychiatric literature on neuroimmunity and behavioral management. This article reviews the epidemiology, diagnosis, pathophysiology, and management of this disease from a neuropsychiatric perspective.
A Young Reporter Chronicles Her 'Brain On Fire'
"When you think about the symptoms — in my case alone, this grandiosity, this violence. In a lot of children, you see hypersexuality. Even my grunts and these guttural sounds that came from me sounded superhuman to someone who might be inclined to think that way. ... When you see videos of people — in fact, when I see videos of myself — demonic possession is not far from your mind.
ALiEM Bookclub: Brain on Fire – My Month of Madness
Cahalan’s book forces the reader to take a hard look at the current methods of medical training. In medical and nursing training, our focus is on understanding pathology, diagnosing disease, and acquiring the language of medicine. During the time patients spend in our care, it is common for us to identify them by their disease—for example, the chest pain in room 5, or the laceration in the hallway. In Brain on Fire, Cahalan recounts her experience during medical rounds after she is diagnosed with Anti-NMDAR encephalitis...
Anti-N-methyl-D-aspartate (NMDA) Receptor Encephalitis – A Synopsis
Anti- N-methyl-D-aspartate (NMDA) receptor encephalitis is a fascinating disorder that was first described in 2007. Initially thought to be exclusively a paraneoplastic disorder occurring in young females with an ovarian teratoma, it is now recognised that this syndrome can occur in children and adults with or without a tumour.
Anti-NMDA-receptor encephalitis: A review
Beyond the neonatal period, this unique autoimmune encephalitis is more common than any specific form of infectious encephalitis, including the herpes simplex virus.
August 2014, my own month of madness!
I stuck my arms up in front of me like a zombie and started violently shaking. I was also drooling salvia and blood where I had bit my tongue and lips 3 different times. I fell unconscious after this.
Could Your Loved One Have Autoimmune Encephalitis?
Imagine a neurologic disease that mimics what it feels like to inexplicably lose your mind. One minute, you’re a healthy young woman whose biggest concern is acing a test in your college chemistry class. Suddenly, you start having hallucinations and delusions. Then, you progress to seizures and catatonia, which can mean you’re awake but don’t respond to anything or anyone, the US National Library of Medicine (NLM) says. Finally, you slip into a coma and don’t wake up until weeks or months go by.
New treatment for a rare form of encephalitis
Anti-NMDA receptor encephalitis is an inflammatory disease that affects the central nervous system. It is a rare autoimmune disease that results in the body producing antibodies against the NMDA receptor, a protein that plays an important role in signal transduction in the brain. Using a new treatment regimen, researchers have recorded significant progress in treating the disease, including in patients who did not previously respond to treatment.
NMDA Encephalitis – The New Encephalitis on the Block!
This topic WILL change the way you think about AMS in young people! We have been missing this disorder and it is treatable!
Anti-NMDA Receptor Encephalitis - An Inside Look
Sheila was driving everyone crazy. Sheila was loud, excitable, erratic, and messy. Really messy.
Anti-NMDA Receptor Encephalitis Foundation
The Anti-NMDA Receptor Encephalitis Foundation exists for all patients and caregivers, at all stages of illness and recovery. Together we will continue the battle; we will encourage those in the trenches; and we will fight for the memory of those no longer with us. Join us in our goals to promote awareness, provide support, and raise funds for research committed to understanding and ending this and related diseases.
Autoimmune Encephalitis Alliance
The Autoimmune Encephalitis Alliance promotes collaboration to improve care, find a cure and create community so that no one faces autoimmune encephalitis alone.
Encephalitis Society
At onset, the most distinctive features include prominent psychiatric symptoms, seizures, confusion and memory loss. Patients will sometimes show bizarre and often rather disturbing behaviours. They may see things which aren’t there, develop strange beliefs or appear agitated. Typically 10 to 20 days later, patients develop a movement disorder, variations in blood pressure, heart rate and temperature and may become less conscious. The movement disorder often consists of continuous writhing and twitching of face and limbs but can also be a generalised slowing-down of movement. Most patients develop several of these features, but very rarely individual patients may experience only a few of these features.
International Autoimmune Encephalitis Society
The International Autoimmune Encephalitis Society is a Family/Patient centered organization that assists patients from getting a diagnosis to recovery and the many challenges experienced throughout that journey.
Jenny's Blog
My life before, during and after autoimmune limbic encephalitis with positive NMDA receptors.
Sophie Gwyther
Life before, during and after NMDAR Encephalitis.
ALiEM
Although only first reported as a diagnosis in 2007, an exponential number of cases have since been described, suggesting that the disease is not rare but rather under-diagnosed. Emergency physicians play an important role in recognizing this disorder, as prognosis is largely dependent on early treatment with immunotherapy.
BC Emergency Medicine Network
The classic presentation is subacute onset psychiatric symptoms with non-specific neurological complaints (e.g. movement abnormalities, speech disorder), often with a preceding viral prodrome. Compared to primary psychiatric diagnoses, the onset tends to be more rapid and there are more mixed symptoms (e.g. rapidly fluctuating agitation/catatonia, mania/depression, pressured speech/mutism).
First10em
Emergency department management is supportive, focusing on control of psychosis, seizures, and autonomic instability. Empiric treatment for meningitis and herpes encephalitis should also be started, as the results of definitive testing will take a while. Ultimately, the patient will require IVIG, steroids, and plasma exchange.
Life in the Fastlane
Anti-NMDA Receptor Encephalitis is an under-recognised progressive neurological disorder caused by antibodies against NR1-NR2 NMDA receptors. 60% of patients with anti-NMDA receptor encephalitis have the presence of a tumour (most commonly teratoma)
WikEM
Anti-NMDA receptor encephalitis is an under-recognized neurologic described disorder described in 2007 due to antibodies to the NMDA receptor and is often associated with GYN tumors (most commonly ovarian teratoma).
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