Encefalitis por Anticuerpos contra el Receptor NMDA: un diagnóstico diferencial neuropsiquiátrico

NMDA Receptor Antibody Encephalitis is a challenge due to the wide list of diagnostic possibilities that the initial symptomatology resembles. It is a disease whose physiopathology is given by the generation and action of antibodies, mostly induced by external agents (virus) and internal agents (some tumors), on NMDAR (N-methyl-D-aspartate receptor) that can occur with neurological, psychiatric and autonomic alterations, usually affecting young adult female population and sometimes being part of a paraneoplastic syndrome. Its management is based on immunotherapy with corticosteroids, intravenous immunoglobulin or in refractory cases, plasmapheresis. The effectiveness of these therapies increases with the opportune diagnosis, however frequently the treatment is applied late due to the difficulty of the correct diagnosis. We present the clinical case of a 22 year-old female, who debuted with neuropsychiatric manifestations, initially medicated with antipsychotics and developed rigidity, increased creatine kinase and epileptic status, for which neuroleptic malignant syndrome was suspected, meriting hospitalization in the intensive care unit. In view of the lack of improvement, the diagnosis was reconsidered, with suspicion of autoimmune encephalitis and specific treatment was established, with which the patient managed to return to her daily life without deficit.