title: Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Review and Neuropsychological Case Study.
abstract: OBJECTIVE
  Anti-N-Methyl-d-Aspartate Receptor (NMDAR) Encephalitis is an autoimmune-mediated encephalitis, which may be associated with a tumor, which occurs when antibodies bind central NMDA receptors. Although typically diagnosed in women, approximately 20% of cases have been males. Due to the challenges with identification, imaging, and diverse symptom presentation, this syndrome is often misdiagnosed. Accurate diagnosis may provide an opportunity for introduction of disease-modifying therapies, which may alter disease trajectory. Moreover, neuropsychology has yet to fully clarify the pattern of impairments expected with this disorder.
  
  
  METHODS
  This manuscript reviews a single case study of a 42-year-old male diagnosed with NMDAR encephalitis. Neuropsychological evaluation was completed subsequent to diagnosis, treatment, and rehabilitation. Ongoing patient complaints, approximately six months post diagnosis, included reduced sustained attention, poor word retrieval, and daily forgetfulness. Adaptive skills were improved following rehabilitation.
  
  
  RESULTS
  Direct testing revealed mildly impaired sustained attention, processing speed, oral word fluency, and executive functioning. All other cognitive domains were within estimated premorbid range, low average to average.
  
  
  CONCLUSIONS
  Neuropsychological deficits were consistent with mild frontal brain dysfunction and continued recovery. This case illustrates the need for medical and psychological practitioners to understand NMDAR encephalitis, its symptom presentation, and related neuropsychological impact; particularly with the potential for misdiagnosis.
authors.affiliation: a Department of Neurology , Virginia Commonwealth University , Richmond , VA , USA.
authors.forename: Ashlee R
authors.initials: AR
authors.lastname: Loughan
authors.affiliation: b Clinical Psychology , University of South Carolina , Aiken , SC , USA.
authors.forename: Aislyn
authors.initials: A
authors.lastname: Allen
authors.affiliation: c TIRR Memorial Hermann , Houston , TX , USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Perna
authors.affiliation: d Department of Neurology , Virginia Commonwealth University , Richmond , VA , USA.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Malkin
mesh_terms: D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D001921:Brain / Q000503:physiopathology; D056344:Executive Function; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D009483:Neuropsychological Tests
keywords: Anti-N-Methyl-d-Aspartate Receptor Encephalitis; Autoimmune-mediated encephalitis.; Cognition; Executive dysfunction