Atypical Presentation of Anti-NMDAR Encephalitis in an Elderly Male With Dominated Memory Impairment From Damascus...

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a rare but serious autoimmune disorder that is typically characterized by a broad spectrum of psychiatric and neurological symptoms. In the academic literature, memory deficits often occur alongside psychiatric symptoms, seizures, motor dysfunctions, and other cognitive issues; it is rare to find it dominated by memory impairment with only one previous seizure. We present a unique presentation of anti-NMDAR encephalitis in a 70-year-old Middle Eastern male patient who primarily exhibited memory impairment along with one unrepeated recent seizure. The patient's initial clinical picture did not align with the classic presentation of anti-NMDAR encephalitis, which often includes prominent psychiatric symptoms and neurological features of motor dysfunction. However, brain magnetic resonance imaging (MRI), electroencephalography (EEG), and the presence of anti-NMDAR antibodies in the cerebrospinal fluid support the diagnosis. Physicians should be aware to consider anti-NMDAR encephalitis in patients with memory impairment and a single previous seizure, even in the absence of typical psychiatric or neurological features.