Anti-NMDA Receptor Encephalitis – Board-Style Questions

What this deck covers

anti-NMDA receptor encephalitis in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. The confirming sample
2. How toddlers present
3. What else to look for
4. Reading the tracing
5. A reassuring scan
6. Worse after the virus
7. After the injection
8. Breathing slows
9. Not a primary psychosis
10. The first treatment
11. Ten days to wait
12. Found on the scan
13. No better at two weeks
14. The long road back
15. Could it come back
16. Six months on
17. Calming the agitation
18. What guides the plan

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Herpes simplex PCR on a repeat cerebrospinal fluid sample, Seizures and abnormal movements, not psychosis, A bone marrow aspirate to look for acute leukaemia, Burst suppression, No abnormality in most patients, A relapse of the herpes infection despite the negative PCR test, Serotonin syndrome from an unknown extra drug, Diaphragm fatigue from the dyskinesias alone, Orofacial dyskinesias with a falling conscious level, Oral prednisolone alone at a low dose for four weeks at home, Start antipsychotics and wait for the antibody result, Radiotherapy to the pelvis to shrink the lesion, Rituximab as second-line immunotherapy, Most remain in a vegetative state for the rest of life.

Clinical pearls from this deck

• Confirm it in the fluid: antibodies to GluN1.
• Toddlers: seizures and writhing before any psychosis.
• Teenage girl with the antibody: scan the ovaries.
• Fast activity riding on delta waves: a brush pattern.
• Normal scan, very sick child: do not be reassured.
• Chorea weeks after herpes: an autoimmune second hit.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Neurology case decks · pediatric reference values.