• Users Online: 151
  • Print this page
  • Email this page
Year : 2021  |  Volume : 7  |  Issue : 1  |  Page : 66-69

Nonparaneoplastic anti-N-methyl-D-aspartate receptor encephalitis with subclinical hyperthyroidism associated with thyroid antibodies

1 Department of Psychiatry, Alluri Sitarama Raju Institute of Medical Sciences, West Godavari, Andhra Pradesh, India
2 Department of Neurology, Alluri Sitarama Raju Institute of Medical Sciences, West Godavari, Andhra Pradesh, India

Correspondence Address:
Dr. Sukeerthi Busi
H. NO: 1-3-204, Suneetha Nilayam, Near Indira Market, Sirpur Kagaznagar, Komaram Bheem - 504 296, Telangana
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjp.tjp_15_21

Rights and Permissions

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disorder with neuropsychiatric symptoms. It is most often misdiagnosed initially as a primary psychiatric disorder. Young women in the background of ovarian teratomas, viral infections are most commonly impacted. Recently, the coexistence of anti-thyroid antibodies with anti-NMDAR antibodies in nonparaneoplastic anti-NMDAR encephalitis has come to light. A 32-year-old married female presented with sudden onset of disruptive and ritualistic behavior, decreased need for sleep, preceded by spikes of high-grade fever, chills, and rigor. Later, she developed episodes of catatonia alternating with spontaneous speech associated with shouting and crying spells. Blood investigations (except for hyperthyroidism and anti-thyroid antibodies), brain imaging, electroencephalogram, and cerebrospinal fluid (CSF) analysis were normal. She was treated with lorazepam (to a maximum of 16 mg), antipsychotics, antidepressants, anticonvulsants, dopaminergic, and steroid drugs with no significant improvement. CSF analysis was repeated for the encephalitis panel and revealed anti-NMDAR encephalitis. The patient was started with intravenous immunoglobulin for 5 days which led to significant clinical improvement. Screening for encephalitis is considered necessary in patients with altered behavior, not responding to symptomatic psychotropic and neurological treatments.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded20    
    Comments [Add]    

Recommend this journal