Diagnostic Errors and Delayed Diagnosis of Autoimmune Encephalitis in Young Patients: Focus on Anti-NMDA Receptor Encephalitis
Keywords:
Autoimmune encephalitis, Anti-NMDA receptor, Diagnostic errorAbstract
Autoimmune encephalitis is an inflammatory disorder of the central nervous system that is potentially reversible when recognized and treated promptly. Among its subtypes, anti-NMDA receptor encephalitis is one of the leading causes of autoimmune encephalitis in children, adolescents, and young adults; however, diagnosis is frequently delayed because early manifestations are predominantly psychiatric. The aim of this narrative review was to analyze the main causes of diagnostic errors and delayed recognition of this disorder while summarizing a practical clinical approach for its early identification. A review of recent literature, including narrative reviews, observational studies, and clinical practice recommendations, was conducted to evaluate diagnostic criteria, clinical manifestations, and therapeutic strategies. Current evidence indicates that misdiagnosis as a primary psychiatric disorder, delayed cerebrospinal fluid antibody testing, and underrecognition of neurological warning signs are the main contributors to delayed diagnosis. Early clinical suspicion and timely initiation of immunotherapy are consistently associated with improved functional recovery and reduced long-term neurological disability.
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