Rehabilitation for a child with recalcitrant anti-N-methyl-d-aspartate receptor encephalitis: case report and literature review

Physical Therapy Interventions and Outcome Measures for a Patient Diagnosed with Anti-NMDA Receptor Encephalitis

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is the most common cause of autoimmune encephalitis after acute demyelinating encephalitis. Patients usually present with acute behavioral changes, psychosis, and abnormal limb movements and can also present with symptoms of catatonia. Treatment typically consists of an immunotherapy protocol consisting of intravenous immunoglobulin, corticosteroids, and plasmapheresis. This article describes the medical treatment, physical therapy (PT) interventions, and outcomes of a 16-year-old patient with anti-NMDA receptor encephalitis with malignant catatonia. Using PT interventions such as bed mobility, transfer, and gait training, and parent education initially, and progressing to balance re-education and age-appropriate functional tasks the patient was able to progress and be discharged to home with family with a recommendation for continued PT treatment in the outpatient setting. [Pediatr Ann. 2021;50(10):e437-e443.].