IS RITUXIMAB AN EFFECTIVE TREATMENT FOR REFRACTORY ANTI-NMDA RECEPTOR ENCEPHALITIS?

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder in which antibodies target NR1/NR2 heteromers of the NMDA receptor in the brain (Ishiura et al., 2008). It is characterized by severe psychiatric and neurological symptoms such as memory loss, seizures, decreased consciousness, autonomic dysregulation, and dyskinesias (Kuppuswamy, Takala, & Sola, 2014). Most commonly affecting young females, and frequently associated with ovarian teratoma (Ishiura et al., 2008). The diagnosis is confirmed by the presence of antibodies in CSF (Kayser & Dalmau, 2016). The definitive treatment of anti-NMDA receptor encephalitis still remains unclear (Ishiura et al., 2008). This case report of a patient with anti-NMDA receptor encephalitis presented with schizophrenic psychosis and status epilepticus illustrating a complete recovery to baseline in two weeks after aggressive treatment of rituximab infusion.