Anti-NMDA receptor encephalitis is an inflammation of the brain. The medical term for encephalitis is encephalitis. Because antibodies to the NMDA receptor are present in this particular form of inflammation, this is called anti-NMDA receptor encephalitis.

What is an anti-NMDA receptor encephalitis?

The causes responsible for the development of anti-NMDA receptor encephalitis have not yet been adequately investigated. Based on current knowledge, however, it can be assumed that specific genetic factors influence the disease.
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Anti-NMDA receptor encephalitis was classified as a disease only a few years ago. Together with various other infectious diseases of the brain, which were previously largely unrecognized, the disease has been increasingly explored since 2000. However, there is currently little data available on the frequency of anti-NMDA receptor encephalitis.

With relatively high probability, however, it can be stated that about 80 percent of all patients are female. The average age at which the disease occurs is 23 years. The age range of patients ranges from 22 months to 79 years.

It is also noteworthy that not only humans can develop anti-NMDA receptor encephalitis, but also other mammals. Polar bear Knut from the Berlin Zoo also died of anti-NMDA receptor encephalitis.

causes

The causes responsible for the development of anti-NMDA receptor encephalitis have not yet been adequately investigated. Based on current knowledge, however, it can be assumed that specific genetic factors influence the disease. Because anti-NMDA receptor encephalitis is an autoimmune disease.

Medical research shows that autoimmune diseases in most cases have a genetic component. This argument is supported by the enormous difference in the frequency of the disease in women and men. It must also be considered that certain inflammations promote the onset and onset of anti-NMDA receptor encephalitis.

Because a large part of those affected suffers from infections at the beginning of the disease. However, anti-NMDA receptor encephalitis is not an infectious disease. Above all, the disease is not transferable to other people, such as viral infections. Since anti-NMDA receptor encephalitis is an autoimmune disease, the organism produces antibodies against the so-called NMDA receptor in the brain.

It is a protein that is important for the transmission of signals in the brain. In addition, about 60 percent of adults suffer from an ovarian tumor associated with anti-NMDA receptor encephalitis. In other patients, in turn, no underlying diseases show.

Symptoms, complaints & signs

Anti-NMDA receptor encephalitis is manifested in a variety of cases with flu-like symptoms. Patients also complain of sleep and loss of appetite as well as states of confusion. In addition, there are often psychological symptoms ranging from anxiety and bizarre behaviors to delusions and hallucinations.

Because of this, a majority of sufferers first go into psychiatric therapy. Epileptic seizures and disturbances of consciousness often occur over the course of a few weeks. Other potential symptoms of anti-NMDA receptor encephalitis include dysphagia and involuntary movements, including immobility.

Also cardiac arrhythmias, impaired breathing and fluctuations in blood pressure and body temperature are possible. Observations suggest that anti-NMDA receptor encephalitis may lead to autism-like symptoms in older children.

Diagnosis & History

For the reliable diagnosis of anti-NMDA receptor encephalitis, a number of examination methods are available. The treating specialist decides on the diagnostic procedure depending on the individual case. So far, immunoglobulins from class G were found in all patients. In addition, 30% of patients were found to be immunocompromised.

Currently, the implementation of these tests worldwide is not uniform. Due to various laboratory methods, it is possible that an anti-NMDA receptor encephalitis is overlooked, even if those affected show the corresponding symptoms. The suspicion of the presence of anti-NMDA receptor encephalitis is usually based on the clinical syndrome.

An increased number of cells in the cerebrospinal fluid also indicates the disease. The detection of endogenous antibodies against the NMDA receptors both in the serum and in the cerebrospinal fluid confirms the diagnosis. In addition, many patients show changes in the EEG. About half of the individuals also have brain changes that are visible by magnetic resonance imaging.

When should you go to the doctor?

Unfortunately, the anti-NMDA receptor encephalitis is detected relatively late, since the symptoms of a flu or a cold are very similar, so that the disease is diagnosed late. The person concerned should, however, then consult a doctor if it comes to an anorexia or insomnia.

Especially with prolonged complaints a doctor should be consulted. Likewise, personality changes, personality disorders, anxiety, or lack of awareness may indicate anti-NMDA receptor encephalitis, and should definitely be investigated by a physician.

It is also not uncommon to have heart or breathing problems, so sufferers need a physical exam. Furthermore, hallucinations or dysphagia may also indicate anti-NMDA receptor encephalitis. Especially in children, early diagnosis and treatment is necessary to avoid further complications. Children can also show symptoms of autism.

As a general rule, anti-NMDA receptor encephalitis can be consulted by a general practitioner. The treatment of this disease is usually done by a procedure that removes the tumor. Furthermore, psychological treatments are necessary. The relatives or parents may also be dependent on psychological treatment.

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Treatment & Therapy

In the course of an anti-NMDA receptor encephalitis, the use of psychotropic drugs is usually necessary. The aim of this drug treatment is to calm the patients and reduce anxiety and psychotic symptoms. In addition, it is attempted to suppress with the help of immunosuppressive drugs the faulty defense reactions of the organism.

In most cases, intravenous immunoglobulins and glucocorticoids are used. If a patient suffers from a tumor, its removal is necessary. The prognosis of anti-NMDA receptor encephalitis is overwhelmingly positive. About 75 percent of sufferers can be cured or only have mild neurological damage from the disease. About 21 percent carry serious neurological impairments from the disease.

About four percent of those affected die from anti-NMDA receptor encephalitis. Basically, the prognosis is better in persons who suffer from a tumor, which is eventually removed. If the disease is detected and treated early, the chances of a complete cure are very good.

Outlook & Forecast

A sick person can expect relief and symptom relief only in inpatient treatment. Without it, there is an increase in the existing symptoms and other symptoms. If the disease remains unrecognized and left untreated, it can be fatal.

The inflammatory process of the brain can proceed unhindered without intervention and lead to a failure of individual systems. Ultimately threatens a collapse of the system with fatal consequences. Without competent medical care, the risk of loss of life and the existence of lasting damage increase considerably.

If intensive care treatment takes place in good time, the chances of recovery depend on the progress of the disease. If anti-NMDA receptor encephalitis is detected early, there are good drug treatments available. In these cases, the patient can expect a hospital discharge after a few weeks. Nevertheless, aftercare is necessary and there is a risk of relapse.

It is not yet possible to make a long-term prognosis because the disease is a recently discovered disease. It was diagnosed for the first time a few years ago, so the research is not yet fully completed. It is already known that even after several years after the onset of the disease with targeted therapies, an improvement of the current state of health can be achieved.

prevention

Since anti-NMDA receptor encephalitis has not yet been sufficiently researched, no reliable statements on measures for the prevention of the disease are possible so far. Since it is an autoimmune disease with a genetic component, it can be assumed that preventive measures, with the exception of preventive examinations, may not even exist.

aftercare

Follow-up is usually relatively difficult with anti-NMDA receptor encephalitis, so patients are primarily dependent on the medical treatment of this disease. However, complete healing can not always be guaranteed so that life expectancy may be reduced. The treatment of anti-NMDA receptor encephalitis is usually done with the help of medication.

Patients should pay attention to the regular and correct use of the drugs and also consider possible drug-drug interactions to avoid complications and other medical conditions. The sooner the anti-NMDA receptor encephalitis is detected, the higher the chance of complete healing. If the anti-NMDA receptor encephalitis is caused by a tumor, it usually has to be surgically removed.

After such surgery, sufferers should always rest and not unnecessarily strain their body. Also stress is always to be avoided. Furthermore, regular examinations of the body for cancer are useful to prevent the spread of the tumor. In general, contact with other people affected by anti-NMDA receptor encephalitis can also have a positive effect on the course of the disease, as information is often exchanged.

You can do that yourself

Anti-NMDA receptor encephalitis is a genetic inflammatory disease of the brain. Sufferers suffer from symptom outbreaks increasingly to infections that are not transmissible. With this symptom self-help methods can only be used to a limited extent.

First, bad habits such as smoking, drug, drug and alcohol abuse should be discarded. A light vitamin-rich diet and foods rich in omega-3 fatty acids support the immune system, especially when psychotropic drugs are used.

As fatigue and lack of appetite accumulate, a nutritionally-based diet is an important support in the mental management of the symptom. Immunosuppressive drugs suppress the faulty defense reaction of the organism.

More than half of the symptom-affected adult women have an ovarian tumor. When the disease occurs, self-help should be followed by a thorough gynecological examination. If severe swallowing and cardiovascular complaints occur, the emergency medical service should be called.

In order to be able to cope with everyday life as the symptom progresses, it is advisable to seek help from relatives or third parties. Assisted living or temporary stay in a psychiatric rehabilitation clinic is recommended. The disease can lead to confusion, panic behavior with uncontrollable movements, delusions, hallucinations and epileptic seizures. Thus, the use of sedative drugs with simultaneous psychological care explained.

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