title: Anti-NMDA Receptor Antibody Positivity and Presentations Without Seizure, Involuntary Movement, Hypoventilation, or Tumor: A Systematic Review of the Literature.
abstract: Patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis may remain undiagnosed and untreated with immunotherapy. To investigate specific features and responses to immunotherapy of atypical anti-NMDAR antibody positivity patients, the authors reviewed and evaluated previous case reports/series including patients without seizure, involuntary movement, hypoventilation, or tumor. Of 22 patients identified, 21 responded to immunotherapy. Two patients had neurological/motor symptoms with few/no psychiatric/cognitive symptoms, and eight had both. Twelve patients presented with psychiatric/cognitive symptoms with few/no neurological/motor symptoms, and ≥1 had memory impairment, catatonia, abnormal MRI or electroencephalogram results. The authors recommend lumbar puncture and examination of anti-NMDAR antibodies for patients with these features.
authors.affiliation: From the Department of Psychiatry, Okayama Psychiatric Medical Center, Okayama, Japan (BY); the Department of Psychiatry, Okinawa Miyako Hospital, Miyakojima, Japan (BY); and the Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan (BY, MT).
authors.forename: Bunta
authors.initials: B
authors.lastname: Yoshimura
authors.affiliation: From the Department of Psychiatry, Okayama Psychiatric Medical Center, Okayama, Japan (BY); the Department of Psychiatry, Okinawa Miyako Hospital, Miyakojima, Japan (BY); and the Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan (BY, MT).
authors.forename: Manabu
authors.initials: M
authors.lastname: Takaki
mesh_terms: D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D001323:Autoantibodies / Q000097:blood* / Q000134:cerebrospinal fluid*; D006801:Humans; D007167:Immunotherapy; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D016194:Receptors, N-Methyl-D-Aspartate
keywords: Neuroimmunology; Organic Mental Disorders