Psychiatric manifestations of anti-NMDA receptor encephalitis: neurobiological underpinnings and differential diagnostic implications.
OBJECTIVE
Anti-N-methyl-d-aspartate receptor (NMDA-R) encephalitis is a recently discovered disorder with prominent psychiatric manifestations that is often misdiagnosed. The objective of this review is to raise awareness of the disorder among psychiatrists and to expand upon the diagnostic considerations that arise in the context of the neurobiology and symptomatology of this disorder. We also aim to examine the similarities in terms of symptoms and underlying neurobiology between anti-NMDA-R encephalitis and schizophrenia-spectrum illnesses.


METHODS
The information presented will reflect a review of the literature of the symptomatology and pathophysiology of anti-NMDA-R encephalitis and the role of the NMDA-R in both anti-NMDA-R encephalitis and schizophrenia-spectrum illnesses.


RESULTS
The studies reviewed highlight the role of the NMDA-R in both anti-NMDA-R encephalitis and schizophrenia in terms of symptom presentation and neurobiology. Studies have also begun to identify involvement of NMDA-R antibodies in patients diagnosed with schizophrenia.


CONCLUSIONS
There is an increasing need for psychiatrists to become aware of the disorder and consider it in their differential diagnosis, as they are often the first to be consulted on patients with anti-NMDA-R encephalitis. The similarities identified between anti-NMDA-R encephalitis and schizophrenia-spectrum illnesses also raise questions about a common underlying pathophysiology particularly in regard to the NMDA-R.
Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA.. Electronic address: eleni.maneta@childrens.harvard.edu.
Eleni
E
Maneta
Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Georgina
G
Garcia
D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000175:diagnosis / Q000523:psychology*; D003937:Diagnosis, Differential; D006801:Humans; D011618:Psychotic Disorders / Q000175:diagnosis; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology