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Updated: May 25, 2026

A Simple Cell-based Immunofluorescence Assay to Detect Autoantibody Against the N-Methyl-D-Aspartate (NMDA) Receptor in Blood
Published on: January 9, 2018
Anti-NMDA receptor encephalitis with the initial presentation of psychotic mania
Yen Lin Kuo1, Hsing Fang Tsai, Ming Chi Lai
1Addiction Research Center, National Cheng Kung University, Tainan, Taiwan.
Abstract:
We report a 16-year-old girl with suspected psychotic mania, who subsequently developed amnesia, catatonia, oro-lingual dyskinesia, consciousness disturbance, seizure and respiratory failure. Repeated studies of the cerebrospinal fluid (CSF), viral culture and serology, brain MRI, single photon emission CT scan, and autoimmune profiles were all normal. She was finally diagnosed with anti-N-methyl D-aspartate receptor (NMDAR) encephalitis based on the positive finding of NMDAR antibodies in CSF. Her abdominal CT scan showed no detectable malignancy and pulse steroid therapy failed to have any effect. After administration of intravenous immunoglobulin her consciousness improved gradually. Anti-NMDAR encephalitis, with a characteristic neuropsychiatric syndrome, predominantly affects females with an ovarian tumor and is frequently misdiagnosed as a psychiatric disorder. Immunotherapy and eradication of associated malignancy are the main treatment strategies. Early recognition and early intervention of the disease should improve the outcome.
Insights
This case study highlights anti-N-methyl D-aspartate receptor (NMDAR) encephalitis, a rare neurological disorder. Early diagnosis and immunotherapy are crucial for improving patient outcomes in this condition.
Area of Science:
- Neurology
- Immunology
- Neuroimmunology
Background:
- Anti-N-methyl D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune neurological disorder.
- It often presents with psychiatric symptoms, leading to misdiagnosis.
- The condition predominantly affects young females, sometimes associated with ovarian teratomas.
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