A-58 Unusual Presentation of Anti-NMDAR Encephalitis in a Young Adult Male: A Case Study

Abstract Objective To illustrate an unusual presentation of anti-n-methyl-D-aspartate-receptor (anti-NMDAR) encephalitis in a young adult male. Anti-NMDAR is autoimmune-mediated disorder with psychiatric and neurological features that can have lasting impact on cognition. Unique presentation, diagnosis, assessment are presented. Method Patient 28-year-old, Caucasian male history bipolar disorder. Initial hospital was characterized by headache, tremor, acute altered mental status. Imaging revealed chronic meningitis diffuse leptomeningeal enhancement/multiple cranial nerve enhancement, hydrocephalus, Chiari I malformation. He underwent external ventricular drain (EVD) placement discharged upon stabilization. presented 1 month later symptom recurrence interval development hydrocephalus. CSF studies were positive for NMDAR antibody. treated immunotherapy. His 3-month long hospitalization complicated respiratory failure intracerebral intraventricular hemorrhages. to inpatient rehabilitation. Results Neuropsychological completed 4 months following discharge from Visual deficits due grade papilledema testing. frontal (focused attention, processing, executive functions), intact verbal learning/memory. This deviates previous literature specify memory dysfunction as core long-term outcome anti-NMDAR encephalitis. Conclusions case highlights neuropsychological Rare presentations preclude clinical diagnosis compromise cognitive outcomes if not rapidly effectively treated. Additionally, mood symptoms may been early manifestation the patient’s disease process. Despite complications, he demonstrated remarkable functional recovery.