Extreme delta brush patterns guide the complex motor phenomenon of anti-NMDA receptor encephalitis: A case report.

RATIONALE

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease that is associated with cell-surface NMDAR-targeting autoantibodies. Typical anti-NMDAR encephalitis symptoms include psychosis, seizure and extrapyramidal side effects. However, early diagnosis of anti-NMDAR encephalitis remains challenging due to the complexity of the motor phenomenon.

PATIENT CONCERNS

Here, we report a new diagnosis of anti-NMDAR encephalitis in a young woman with a history of epilepsy.

DIAGNOSES

Electroencephalography revealed a typical "extreme delta brush" pattern, which indicated anti-NMDAR encephalitis.

INTERVENTIONS

The clinical status of the patient markedly improved after immediate and aggressive immunosuppression therapies.

OUTCOMES

The patient was discharged with mild cognitive impairment. However, this was completely resolved 1 month postdischarge.

LESSONS

We conclude that subacute onset focal seizure with psychosis as well as compatible electroencephalography findings (i.e., extreme delta brush patterns) should be considered notable early indicators of anti-NMDAR encephalitis. This would ensure early and effective clinical interventions, which are essential for favorable outcomes.