Anti-NMDA receptor antibody positivity and presentations without seizure, involuntary movement, hypoventilation, or tumor

A systematic review of the literature

Bunta Yoshimura, Manabu Takaki

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis may remain undiagnosed and untreated with immunotherapy. To investigate specific features and responses to immunotherapy of atypical anti-NMDAR antibody positivity patients, the authors reviewed and evaluated previous case reports/series including patients without seizure, involuntary movement, hypoventilation, or tumor. Of 22 patients identified, 21 responded to immunotherapy. Two patients had neurological/motor symptoms with few/no psychiatric/cognitive symptoms, and eight had both. Twelve patients presented with psychiatric/cognitive symptoms with few/no neurological/motor symptoms, and ≥1 had memory impairment, catatonia, abnormal MRI or electroencephalogram results. The authors recommend lumbar puncture and examination of anti-NMDAR antibodies for patients with these features.

Original languageEnglish
Pages (from-to)267-274
Number of pages8
JournalJournal of Neuropsychiatry and Clinical Neurosciences
Volume29
Issue number3
DOIs
Publication statusPublished - Jun 1 2017

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Hypoventilation
Dyskinesias
N-Methyl-D-Aspartate Receptors
Seizures
Antibodies
Neoplasms
Immunotherapy
Neurobehavioral Manifestations
Psychiatry
Anti-N-Methyl-D-Aspartate Receptor Encephalitis
Catatonia
Spinal Puncture
Electroencephalography

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

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title = "Anti-NMDA receptor antibody positivity and presentations without seizure, involuntary movement, hypoventilation, or tumor: A systematic review of the literature",
abstract = "Patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis may remain undiagnosed and untreated with immunotherapy. To investigate specific features and responses to immunotherapy of atypical anti-NMDAR antibody positivity patients, the authors reviewed and evaluated previous case reports/series including patients without seizure, involuntary movement, hypoventilation, or tumor. Of 22 patients identified, 21 responded to immunotherapy. Two patients had neurological/motor symptoms with few/no psychiatric/cognitive symptoms, and eight had both. Twelve patients presented with psychiatric/cognitive symptoms with few/no neurological/motor symptoms, and ≥1 had memory impairment, catatonia, abnormal MRI or electroencephalogram results. The authors recommend lumbar puncture and examination of anti-NMDAR antibodies for patients with these features.",
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