Uskudar University, Turkey
Title: Anti-NMDA Encephalitis
Prof. Nevzat Tarhan became a Psychiatrist in GATA in 1982. He became a professor of psychiatry in 1996. In 1998, he became the representative of Turkey in Memory Center of America. As Tarhan closely observes the social life due to being a psychiatrist, he makes an accurate analysis of the social life and touches on the importance of "Community Psychology" in every media platform.
Prof. Nevzat Tarhan has always targeted investment in people and used his material-spiritual resources towards this direction. He expresses through his actions that he will continue the same objectives until the end of his life, under his approach of the faith. Currently, he is the Founder and Rector of the Üsküdar University and carries out the NPÄ°STANBUL Brain Hospital Chairman of the Board of Directors, which is Turkey's first neuropsychiatry hospital. He has more than 100 publications, of which 31 are international. He speaks English and German.
Anti-NMDA receptor encephalitis was firstly described in 2007. Up-to this date more than 400 cases have been described, making the syndrome rather unrare. It is an autoimmune disorder where the NMDA receptors are targeted. The disease may affect anyone at any age and any gender. The patients usually have a viral-like prodrome of lethargy, upper respiratory symptoms, headache, nausea, fever…etc. The presenting symptoms of the syndrome are mainly psychiatric. The patients manifest various psychotic symptoms like delusions, disorganized thoughts and behaviours, paranoid ideation, hallucinations, mood lability and cognitive deterioration. After 1-3 weeks of neuropsychiatric symptoms, the patient suffers from neurological complications such as global alterations in consciousness, catatonic-like states, dysautonomia and seizures. The patients may need to be hospitalized for 3-4 months. Agressive treatment with corticosteroids and immunotherapy is needed. Most patients respond to this treatment. However, they may have significant cognitive and behavioral abnormalities like deficits in executive functions, impulsivity, behavioral disinhibition, and sleep disturbances that need further follow-up. Psychiatric and neurological symptoms are treated with psychotropic drugs as in other neuropsychiatric syndromes. Some patients may need neurorehabilitation. The diagnosis requires cerebrospinal fluid (CSF) work-up. In CSF lymphocytic pleocytosis, elevated protein and oligoclonal bands are found. Demonstrating antibodies against NMDA receptors in CSF and/or serum gives a solid diagnosis of the disease. Cranial magnetic resonance imaging (MRI) may be normal in half of the cases. Electroencephalography (EEG) is usually abnormal with slowed and disorganized activity.