Joycel Angelique F Chua¹*, Rana Mae M Calib² and Eliza S Malazarte²

¹Neurological Unit, National Center for Mental Health, Mandaluyong City, Philippines
²National Center for Mental Health, Mandaluyong City, Philippines

*Corresponding Author: Joycel Angelique F Chua, Neurological Unit, National Center for Mental Health, Mandaluyong City, Philippines.

Received: June 08, 2026; Published: July 01, 2026

Abstract

Background: Anti-NMDAR encephalitis and ADEM are different disease entities which can present with similar symptoms of neuropsychiatric disturbances, seizures, cognitive impairment, and other focal deficits. It is easy to exclude one from the other, especially for patients presenting with nonspecific symptoms.

Methods: This is the case of a 31-year-old male from the Philippines who presented with behavioral changes and refractory seizures.

Results: He was initially treated as a case of substance use disorder at our psychiatric hospital but later diagnosed with Anti-NMDAR Encephalitis and Acute Disseminated Encephalomyelitis. His CSF tested positive for both anti-NMDAR and oligoclonal bands, and his cranial MRI showed T2 Flair hyperintensities over the left cerebral hemisphere with cortical enhancement and thickening. He was treated with high-dose methylprednisolone for 5 days followed by oral steroids. His seizures stopped after steroids, and he demonstrated significant clinical improvement. His cranial MRI also showed interval resolution of the lesions.

Conclusions: ADEM and anti-NMDAR encephalitis can occur simultaneously in a patient. Even though their specific biomarkers and neuroimaging present differently, the treatment is essentially the same. Patients are treated with high-dose steroids, intravenous immunoglobulin, or plasmapheresis followed by immunomodulating therapies as warranted to prevent risk of relapse.

Keywords: Demyelinating Diseases; Anti-Nmdar; Encephalitis; Neuroimmunology; Psychiatry; Seizures

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Citation

Citation: Joycel Angelique F Chua., et al. “A Case of Anti-NMDAR Encephalitis presenting as Acute Disseminated Encephalomyelitis (ADEM) in a Psychiat- ric Hospital". Acta Scientific Neurology 9.7 (2026): 15-20.

Copyright

Copyright: ©2026 Joycel Angelique F Chua., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.