Anti-NMDA Receptor Encephalitis in a Patient with a History of Autism Spectrum Disorder

Author(s): Xavier Diao*, Milana Mor

Journal Name: Adolescent Psychiatry

Volume 10 , Issue 3 , 2020

Become EABM
Become Reviewer
Call for Editor


Background: Anti-NMDA receptor (NMDAR) encephalitis is an autoimmune syndrome characterized by a well-described constellation of neuropsychiatric symptoms. Its exact pathophysiology is poorly understood, but it is thought to be mediated by autoantibodies against NMDA (N-methyl-D-aspartate)-type glutamate receptors in the central nervous system. There is ongoing literature to suggest that patients with autism spectrum disorder (ASD) have evidence of neuroinflammation—or by definition, encephalitis.

Objective: To investigate the link between autism spectrum disorder and autoimmune encephalitides.

Methods: We present a case of anti-NMDA receptor encephalitis in a patient with autism spectrum disorder. “OP” is a 16-year-old male with a history of attention-deficit/ hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) who presented with a 3-day history of acute-onset altered mental status, electroencephalogram (EEG)-corroborated seizures, and slurred speech. Laboratory studies were significant for serum- and cerebrospinal fluid (CSF)-positive NMDA antibodies. The child psychiatry consult-liaison service was consulted for significant agitation and behavioral dyscontrol. We recommended 1:1 observation for safety, as well as antipsychotic agents titrated to clinical effect. The patient had a protracted hospital course, but was eventually discharged to an acute rehabilitation facility for continued stabilization and therapy.

Conclusion: It remains to be seen if the relation between encephalitis and ASD is uni- or bidirectional, that is: whether children with ASD have a genetic diathesis to developing encephalitides (such as those mediated by the NMDAR), or conversely, if deranged or inflamed neuroreceptor processes are implicated in the development of ASD.

Keywords: Anti-NMDA receptor, ASD, cerebrospinal fluid, encephalitis, patient, antipsychotic agents.

open access plus

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2020
Published on: 02 September, 2019
Page: [231 - 235]
Pages: 5
DOI: 10.2174/2211352517666190902144221

Article Metrics

PDF: 33