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Anti-NMDA Receptor Encephalitis Misdiagnosed As Generalized Anxiety Disorder: A Case Report

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Journal Cureus
Date 2021 Dec 27
PMID 34956805
Citations 1
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Abstract

The autoimmune encephalitis is a rare group of neurological disorders mediated by immune mechanisms. Neuropsychiatric symptoms often occur in the early stages of the disease, so many patients seek treatment in psychiatry for the first time. If psychiatrists lack understanding and vigilance of the disease, it is very easy to be misdiagnosed as various primary psychiatric diseases, thus delaying diagnosis and treatment. Here, we report an older woman with autoimmune encephalitis. In the early stage, the patient was misdiagnosed as having generalized anxiety disorder because of obvious psychiatric symptoms, and then caused the doctor's vigilance due to rapidly declining cognitive function, autonomic nervous dysfunction, involuntary movement, and other warning symptoms. Autoimmune encephalitis was diagnosed by cerebrospinal fluid examination, and the patient was cured and discharged after a period of immunotherapy.

Citing Articles

Anti-NMDA receptor encephalitis with initial negative markers: diagnostic and therapeutic challenges of a refractory case with 9-month-long follow-up.

Cascardo C, Ismail A, Fullmer J, Davila F BMJ Case Rep. 2022; 15(6).

PMID: 35764337 PMC: 9240890. DOI: 10.1136/bcr-2022-249126.

References
1.
Chong J, Rowland L, Utiger R . Hashimoto encephalopathy: syndrome or myth?. Arch Neurol. 2003; 60(2):164-71. DOI: 10.1001/archneur.60.2.164. View

2.
Lancaster E, Huijbers M, Bar V, Boronat A, Wong A, Martinez-Hernandez E . Investigations of caspr2, an autoantigen of encephalitis and neuromyotonia. Ann Neurol. 2011; 69(2):303-11. PMC: 3059252. DOI: 10.1002/ana.22297. View

3.
Kayser M, Titulaer M, Gresa-Arribas N, Dalmau J . Frequency and characteristics of isolated psychiatric episodes in anti–N-methyl-d-aspartate receptor encephalitis. JAMA Neurol. 2013; 70(9):1133-9. PMC: 3809325. DOI: 10.1001/jamaneurol.2013.3216. View

4.
Boronat A, Gelfand J, Gresa-Arribas N, Jeong H, Walsh M, Roberts K . Encephalitis and antibodies to dipeptidyl-peptidase-like protein-6, a subunit of Kv4.2 potassium channels. Ann Neurol. 2012; 73(1):120-8. PMC: 3563722. DOI: 10.1002/ana.23756. View

5.
Herken J, Pruss H . Red Flags: Clinical Signs for Identifying Autoimmune Encephalitis in Psychiatric Patients. Front Psychiatry. 2017; 8:25. PMC: 5311041. DOI: 10.3389/fpsyt.2017.00025. View