Introduction: Anti- N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune encephalopathy that is being increasingly diagnosed in children and adolescents with seizures, altered mental status and movement disorders. We report the clinical features and neuropsychological outcomes of three children who were diagnosed with anti-NMDA receptor encephalitis.

Case Description: We describe three children, 2 male and 1 female, with anti-NMDA receptor encephalitis. All three were adolescents, who presented with acute behavioural change, seizures and movement disorders. All cases were seropositive for NMDA receptor antibodies and were not associated with tumours. At presentation, the patients had poor executive function, inappropriate behaviour with disinhibition and impulsivity, as well as memory impairment. Based on serial neuropsychological assessments, these impairments were noted to improve with immunosuppressive therapy. The range of follow-up after diagnosis was 4 months to 4 years. The female patient was followed up for 4 years and although she showed initial clinical improvement, had a relapse after completing therapy which was characterised by acute onset of cognitive decline and behavioural change.

Conclusion: We report the neuropsychological and clinical outcomes of children with anti-NMDA receptor encephalitis. The cognitive deficits associated with this condition reduce in severity over time with immunosuppressive therapy, but executive impairment persists. Children with autoimmune encephalopathies such as anti-NMDA receptor encephalitis should undergo serial neuropsychological assessments to monitor response to therapy and relapse.