Neurological Sciences

, Volume 36, Issue 7, pp 1257–1258 | Cite as

A case of NMDAR encephalitis misdiagnosed as postpartum psychosis and neuroleptic malignant syndrome

  • Ayhan KoksalEmail author
  • Sevim Baybas
  • Belgin Mutluay
  • Yavuz Altunkaynak
  • Aslı Keskek
Letter to the Editor

Dear Editor,

Anti-N-methyl-d-aspartic acid receptor (NMDAR) encephalitis is a rare and recently described disease that is characterized by a neuropsychiatric syndrome and associated with ovarian teratomas [1, 2, 3].

We report a 25-year-old female who presented with insomnia, agitation, irritability and fear of death which began 3 months after a normal delivery. Shortly after that, she developed delusions and hallucinations and psychomotor excitement. Her past medical history as well as that of her family’s was unremarkable. She complained of seeing demons in her dream and believed that they were inside her body and would kill her. She was suspected of having postpartum psychosis and admitted to the psychiatry clinic. She was given risperidone 2 mg/day and benzodiazepine 10 mg/day treatment, but there was no improvement. One week later, she developed confusion, cog-wheel rigidity, fever, increase in serum creatine phosphokinase (CPK) levels, and leukocytosis. She was diagnosed as...


Neuroleptic malignant syndrome NMDAR antibody NMDAR encephalitis Ovarian teratoma Postpartum psychosis 


Conflict of interest

There is no conflict of interest and this report has not been supported financially or other manner.


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    Iizuka T, Sakai F (2008) Anti-NMDA receptor encephalitis—clinical manifestations and pathophysiology. Brain Nerve 60:1047–1060PubMedGoogle Scholar
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    Titulaer MJ, McCracken L, Gabilondo I et al (2013) Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol 12(2):157–165PubMedCentralPubMedCrossRefGoogle Scholar
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    Kumar MA, Jain A, Dechant VE et al (2010) Anti-N-methyl-D-aspartate receptor encephalitis during pregnancy. Arch Neurol 67:884–887PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  • Ayhan Koksal
    • 1
    • 2
    Email author
  • Sevim Baybas
    • 1
  • Belgin Mutluay
    • 1
  • Yavuz Altunkaynak
    • 1
  • Aslı Keskek
    • 1
  1. 1.Department of NeurologyBakirkoy Research and Training Hospital for Neurologic and Psychiatric DiseasesIstanbulTurkey
  2. 2.Department of NeurologyBakirkoy Research and Training Hospital for Psychiatry, Neurology and NeurosurgeryIstanbulTurkey

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