EJMCR. 2017; 1(May 2017): 97-101

Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis

Authors: Noor Adnan Almodihesh.

ABSTRACT

Background: NMDA (N-methyl-D-aspartate, a glutamate receptor) receptor is involved in higher brain functions including learning and memory. Anti-NMDA receptor encephalitis is an autoimmune disorder with complex presentations that includes psychiatric symptoms, memory deficits and autonomic instability. It has been recognized as an important differential diagnosis in patients presented initially with psychiatric manifestations. Patients present variant signs that range from anxiety symptoms and seizure to unresponsive states, which may mislead diagnosis towards psychosis in the emergency department as this disease is a neurological disorder in psychiatric disguise. Case presentation: We present a case of a 6 years old girl with psychiatric manifestations in terms of change in behavioral aspects like being fearful, restless and anxious, which progressed to autonomic instability and decreased level of consciousness within days. EEG was carried out beside anti-NMDA receptor antibodies, and the patient was diagnosed with anti-NMDA receptor encephalitis, which was treated with monoclonal antibody (rituximab) and psychotropic medication, all symptoms subsided and full recovery was obtained after a few months. Conclusion: This case describes a treatable medical condition that may be missed in emergency settings. Hence, the awareness of this disorder is important for diagnosis as acute psychotic episodes. Correct diagnosis and right evaluation can lead to early intervention and better prognosis.

Keywords:
Childhood psychosis, anti-NMDA receptor encephalitis, Autoimmune encephalitis, Paraneoplastic neurological syndromes, acute psychosis, case report


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Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis


Authors
Noor Adnan Almodihesh
Department of Psychiatry, King Khalid Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Correspondence to:
Noor Adnan Almodihesh. Noor Adnan Almodihesh, King Khalid Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia; noor_ad_md@yahoo.com

Publication history
Received 02 Jun 2017
Accepted 03 Jun 2017

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Pubmed Style

Noor Adnan Almodihesh. Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis. EJMCR. 2017; 1(May 2017): 97-101. doi:10.24911/ejmcr/1/22


Web Style

Noor Adnan Almodihesh. Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis. http://www.ejmcr.com/?mno=268081 [Access: October 18, 2018]. doi:10.24911/ejmcr/1/22


AMA (American Medical Association) Style

Noor Adnan Almodihesh. Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis. EJMCR. 2017; 1(May 2017): 97-101. doi:10.24911/ejmcr/1/22


Vancouver/ICMJE Style

Noor Adnan Almodihesh. Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis. EJMCR. (2017), [cited October 18, 2018]; 1(May 2017): 97-101. doi:10.24911/ejmcr/1/22


Harvard Style

Noor Adnan Almodihesh (2017) Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis. EJMCR, 1 (May 2017), 97-101. doi:10.24911/ejmcr/1/22


Turabian Style

Noor Adnan Almodihesh. 2017. Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis. European Journal of Medical Case Reports, 1 (May 2017), 97-101. doi:10.24911/ejmcr/1/22


Chicago Style

Noor Adnan Almodihesh. "Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis." European Journal of Medical Case Reports 1 (2017), 97-101. doi:10.24911/ejmcr/1/22


MLA (The Modern Language Association) Style

Noor Adnan Almodihesh. "Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis." European Journal of Medical Case Reports 1.May 2017 (2017), 97-101. Print. doi:10.24911/ejmcr/1/22


APA (American Psychological Association) Style

Noor Adnan Almodihesh (2017) Rare causes of acute psychiatric manifestation in children: a case report of anti-NMDA receptor encephalitis. European Journal of Medical Case Reports, 1 (May 2017), 97-101. doi:10.24911/ejmcr/1/22


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