Encephalitis Anti-N-Methyl-D-Aspartate Receptor Encephalitis
The vast majority of the excitatory neurotransmission in the central nervous system (CNS) is mediated by vesicular release of glutamate, which activates both pre and postsynaptic G-protein–coupled metabotropic glutamate receptors and ionotropic glutamate receptors (iGluRs). iGluRs are ligandgated cation channels that are divided into three major structurally distinct functional classes: the α-amino-3-hydroxy-5-methyl-4-isoxasolepropionic acid (AMPA) receptors, kainate receptors, and NMDA receptors
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NMDA-type glutamate receptors are ligand-gated ion channels that mediate a Ca2+-permeable component of excitatory neurotransmission in the central nervous system (CNS). They are expressed throughout the CNS and play key physiological roles in synaptic function, such as synaptic plasticity, learning, and memory. NMDA receptors are also implicated in the pathophysiology of several CNS disorders and more recently have been identified as a locus for disease-associated genomic variation.NMDAR encephalitis is a common cause of autoimmune encephalitis, predominantly affecting young adults. Current data supports the idea that autoantibodies targeting NMDARs are responsible for disease pathogenesis. While these autoantibodies occur in the setting of underlying malignancy in approximately half of all patients, initiating factors for the autoimmune response in the remainder of patients are unclear Although the majority of patients achieve good outcomes. Common clinical features include auditory and visual hallucinations, delusions, behavioural change (frequently with agitation), impaired consciousness, motor disturbance (ranging from dyskinesia to catatonia), seizures, and autonomic dysfunction. for Further advances in our understanding of this disease and underlying triggers are necessary to develop treatments which improve outcomes
