Pădureanu Vlad, Dop Dalia, Pădureanu Rodica, Pîrșcoveanu Denisa Floriana Vasilica, Olaru Gabriela, Streata Ioana, Bugă Ana Maria
Department of Internal Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania.
Department of Pediatrics, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania.
Brain Sci. 2025 May 18;15(5):518. doi: 10.3390/brainsci15050518.
Antibodies against the NR1 or NR2 subunits of the NMDA receptor are linked to anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, a type of encephalitis that mainly affects women. Clinicians who treat patients of all ages should be aware of this type of encephalitis since it may be a treatable differential for symptoms and indicators observed in neurology and psychiatric clinics. Auditory and visual hallucinations, delusions, altered behavior (often accompanied by agitation), reduced consciousness, motor disruption (from dyskinesia to catatonia), seizures, and autonomic dysfunction are typical clinical characteristics. In recent years, the incidence of autoimmune encephalitis diagnoses has markedly risen among adults, children, and adolescents. This fact is unequivocally connected to the dynamic evolution of novel diagnostic techniques and the advancement of medical knowledge. A specific variant of this illness is anti-NMDA receptor encephalitis. Psychiatrists frequently serve as the initial specialists to treat patients with this diagnosis, owing to the manifestation of psychiatric symptoms associated with the condition. The differential diagnosis is quite challenging and predominantly relies on the patient's history and the manifestation of characteristic clinical signs. Given its high prevalence, anti-NMDA receptor encephalitis should be included in the differential diagnosis in routine psychiatric treatment. We provide an overview of the research on the condition, covering its prognosis, management, epidemiology, differential diagnosis, and clinical presentation.
针对N-甲基-D-天冬氨酸(NMDA)受体NR1或NR2亚基的抗体与抗NMDA受体脑炎有关,这是一种主要影响女性的脑炎类型。治疗各年龄段患者的临床医生都应了解这种脑炎,因为它可能是神经科和精神科诊所中观察到的症状和指标的可治疗鉴别诊断。听觉和视觉幻觉、妄想、行为改变(常伴有激动)、意识减退、运动障碍(从运动障碍到紧张症)、癫痫发作和自主神经功能障碍是典型的临床特征。近年来,自身免疫性脑炎在成人、儿童和青少年中的诊断发病率显著上升。这一事实与新型诊断技术的动态发展和医学知识的进步明确相关。这种疾病的一种特殊变体是抗NMDA受体脑炎。由于该病伴有精神症状,精神科医生常常是治疗这类患者的首诊专科医生。鉴别诊断颇具挑战性,主要依赖患者病史和特征性临床体征的表现。鉴于其高发病率,抗NMDA受体脑炎应纳入常规精神科治疗的鉴别诊断中。我们概述了关于该病的研究,涵盖其预后、治疗、流行病学、鉴别诊断和临床表现。