Rehabilitation following anti-NMDA encephalitis

Anti-NMDA (N-methyl D-Aspartate) encephalitis is an autoimmune disorder of the central nervous system which presents acutely with seizures, disturbances in consciousness and behavioural change. Although there is an increasing amount of information about the diagnosis and acute treatment strategies, little is known about rehabilitation needs and outcomes for this patient group.

This study presents a 52-year old woman who initially presented with generalized seizures and drowsiness. She was admitted to hospital where autoimmune encephalitis was diagnosed based on a positive serum anti-NMDA antibody titre. When medically stabilized, she was transferred to a specialist neurorehabilitation unit for ongoing care. Her main clinical issues were around behavioural disturbance, communication, continence, mobility and cognition. A multi-disciplinary approach was taken to her problems and she was eventually discharged back to community living having made substantial improvements in all domains of functioning. The clinical challenges encountered throughout her rehabilitation and the approach to ameliorating these is described.

Although having a relatively rare diagnosis, the specific rehabilitation needs of this patient were met through an existing specialist neurorehabilitation service. A broader case series is required to determine needs and effective approaches across this patient group as a whole.