Cognitive profile in anti-NMDAR encephalitis: Neuropsychological evaluation, rehabilitation, and evolution. A case report

Abstract

Encephalitis associated with antibodies against the N-methyl-D-aspartate receptor (i.e., anti-NMDAR encephalitis) is an immune-mediated disorder mainly affecting girls and young women with ovarian teratoma. The clinical picture of the disease progresses from headaches and seizures, psychopathological symptoms (i.e., anxiety, psychosis, or hyperreligiosity), and neuropsychological deficits (i.e., memory, attention, and language disintegration) into a state of agitation, catatonia, dysautonomia (i.e., abnormal movements due to inappropriate muscular activity) and facial dyskinesia. Reports of the neuropsychological profile and evolution, as well as the neuropsychological rehabilitation in anti-NMDAR encephalitis in the literature are scarce. We present the case of a 21-year-old woman diagnosed with anti-NMDAR encephalitis and we describe the different neuropsychological evaluation tests performed before and after neuropsychological rehabilitation during the acute period. A profile of fronto-subcortical neuropsychological damage was observed, with executive functions and emotional regulation affected.