A Case Report on Anti-N-methyl-d-aspartate Receptor Encephalitis in a 52-year-old Female with Schizophrenia

Abstract Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a complex neurological and psychiatric disorder. It often presents with psychiatric symptoms, leading to misdiagnosis, but can progress to severe neurological manifestations. In this study, we presented a 52-year-old woman with a 30-year history of schizophrenia who suddenly developed mutism, agitation, and incontinence. Electroencephalography showed generalized slowing, and autoimmune testing revealed NMDAR antibody positivity. Treatment with intravenous methylprednisone led to rapid improvement, highlighting the importance of considering autoimmune causes in such cases. NMDAR encephalitis is a condition with both neurological and psychiatric symptoms. It is often initially mistaken for psychiatric issues. Physicians should carefully assess and be vigilant in psychiatric cases. If routine tests show no significant issues, but the neurological state worsens, considers NMDAR encephalitis, and acts promptly. Delayed treatment can be harmful.