Center for Autoimmune Neurology

Home # $ Disease Information $ Anti-NMDAR Encephalitis

Personnel Anti-NMDAR Encephalitis

What is anti-NMDA Receptor Encephalitis?
Patient Care Anti-NMDA receptor encephalitis is a neurologic disease first identified by Dr. Josep Dalmau and colleagues at the
University of Pennsylvania in 2007. It is an autoimmune disease, where the body creates antibodies against the

Research NMDA receptors in the brain. These antibodies disrupt normal brain signaling and cause brain swelling, or
encephalitis. It can affect both men and women, however is more common among women. It primarily affects the
young, including children and young adults. Some patients also have a tumor associated with this disease; the most
Disease Information !
common type is an ovarian teratoma in women. The name of this disease describes an immune attack on the NMDA
receptors and can be explained as follows:
Classification
% Anti- Autoimmune Response

Associated Syndromes % NMDA Receptor- against NMDA receptors in the brain

% Encephalitis- causing swelling and disruption in brain signaling

Diagnosis

Signs & Symptoms

Treatment
Anti-NMDA receptor encephalitis causes a wide range of symptoms varying in severity. Patients typically start with
less severe symptoms, and then rapidly progress to a condition requiring hospitalization. The list below includes the
Causes
most common symptoms. Most patients with this disease exhibit nearly all of these symptoms; it is extremely
uncommon for patients to have only one or two.
Anti-NMDAR Encephalitis
% Behavior (paranoia, hallucinations, aggression, etc.)

Resources & Links % Cognition

% Memory Deficit
Search Our Site... " % Speech Disorder

% Loss of Consciousness

% Movement Disorder (rhythmic motions with arms or legs, abnormal movements with the face or mouth)

% Seizures

% Autonomic Dysfunction

Titulaer, et. al., 2013

Diagnosis
Anti-NMDA receptor encephalitis is often first identified through clinical symptoms. Diagnosis is confirmed through
lab testing of cerebral spinal fluid (CSF) or blood serum. This testing is available at a variety of commercial labs,
including the Hospital of the University of Pennsylvania (1-800-PENN LAB).

Treatment
Treatment of anti-NMDA receptor encephalitis can vary according to patient, but typically includes a combination of
the following:

First Line Treatment:

% Tumor removal (if tumor is present)

% Steroids

% Plasma Exchange (plasmapheresis)

% Intravenous immunoglulin (IVIG)

Second Line Treatment:

% CellCept

% Rituximab

% Cytoxan

Recovery
Recovery is slow and typically occurs in reverse of symptom onset. The most severe symptoms typically resolve first
while the cognitive, behavioral, and memory problems take longer to resolve. Most patients will make a full recovery
within two years of disease onset. Predictors of positive outcomes include presence of a tumor, quick diagnosis, and
aggressive treatment including second line therapies.

Causes
Like most autoimmune diseases it is not known what exactly what causes anti-NMDAR encephalitis. There are likely
multiple environmental and genetic triggers that make people more susceptible to this disease, something we hope
to pinpoint with future research.

Top &

Contact Us Links of Interest

Center for Autoimmune Neurology University of Pennsylvania
Philadelphia, PA 19104
Perelman School of Medicine

Penn Neuroscience Center

Neuroimmunology Program: Barcelona, Spain

© The Trustees of the University of Pennsylvania | Site best viewed in a supported browser. | Report Accessibility Issues and Get Help | Privacy Policy | Site Design: DART Web Team.