A 28-year-old woman presents with status epilepticus. She had a prodrome of psychiatric symptoms for 2 weeks before seizures. MRI brain is normal. CSF shows mild lymphocytosis. EEG shows extreme delta brush pattern. Which autoantibody is most likely responsible?
- A Anti-VGKC (LGI1)
- B Anti-NMDA receptor ✓
- C Anti-Hu (ANNA-1)
- D Anti-GABA-B receptor
Correct answer: B. Anti-NMDA receptor
Explanation
Anti-NMDA receptor encephalitis is the most common autoimmune encephalitis, classically affecting young women, presenting with a stereotyped progression: psychiatric prodrome → seizures → movement disorders → decreased consciousness → autonomic instability. The 'extreme delta brush' EEG pattern (delta activity with superimposed beta bursts) is pathognomonic for anti-NMDA receptor encephalitis. Anti-LGI1 (VGKC complex) causes faciobrachial dystonic seizures and hyponatremia. Anti-Hu is a paraneoplastic antibody associated with SCLC.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.