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

Dear Editor,

AntiN-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 [13].

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 …

http://link.springer.com/article/10.1007%2Fs10072-014-1966-3

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