Anti NMDA Encephalitis (Brain on Fire Disease) – Clinical Symptoms and Management

Dr Sanil Rege takes you through the clinical symptoms and treatment of Anti-NMDA encephalitis, also known as brain on fire disease. It a newly discovered condition (2007) highlighted in the book and subsequent movie called ‘Brain on Fire’.

The full name of this disease is Anti- N-methyl-D-aspartate (NMDA) receptor encephalitis, which is why it is sometimes abbreviated as Anti-NMDAR encephalitis.

Anti-NMDA Receptor Encephalitis Symptoms

Anti-NMDAR encephalitis should be suspected in any individual, usually younger than 50 years and especially a child or a teenager, who develops a rapid change of behaviour or psychosis, abnormal postures or movements (mostly orofacial and limb dyskinesias), seizures, and variable signs of autonomic instability, hypoventilation, or both.

As Anti -NMDAR encephalitis is a relatively recent discovery, there is often a delay in diagnosis because of the lack of knowledge and clinical experience about the disorder.

Furthermore, the presence of pronounced psychiatric symptoms can often result in a misdiagnosis of functional psychosis or schizophrenia.

This video covers the main clinical course, red flags and treatment principles for brain on fire disease.

• Brain on fire disease is also closely associated with ovarian teratomas in 50% of cases.
• If detected and diagnosed correctly, the long-term prognosis is good, but increased dissemination of knowledge about the disorder is required for improved accuracy and rapidity of treatment.
• It is also important to recognise that there are currently 16 known disorders with IgG autoantibodies against cell surface or synaptic proteins. Anti-NMDAR encephalitis is one of those 16 disorders.

Read the full synopsis, clinical pearls, management and other important things to know about Brain on Fire disease in our full article on Anti-NMDAR encephalitis.