The study aimed to determine psychiatric symptoms

associated with a positive anti-NMDAR antibody test result in the cerebrospinal fluid (CSF).

A large number of anti-N-Methyl-D-Aspartate receptor (NMDAR)

encephalitis cases may initially present with psychiatric

symptoms. Identifying which psychiatric symptoms facilitate

diagnosis can lead to prompt treatment and better clinical

outcome. 

This is a single center retrospective case control analytic study

which primarily compared psychiatric symptoms of all pediatric

cases of confirmed anti-NMDAR encephalitis (positive anti-

NMDAR antibodies in the CSF) with a control group (pediatric

patients with encephalitis of other causes) admitted from

January 2011 to August 2025 at the Philippine Children’s

A total of 193 pediatric patients were included in the study, 97

(50.2%) of whom were confirmed anti-NMDAR cases. After

adjusting for age and sex, four features emerged as independent

predictors of anti-NMDA receptor encephalitis. Children presenting

with movement disorders were nearly five times more likely to have

anti-NMDAR encephalitis than controls sleep disturbances made

them almost three times as likely, psychosis doubled their odds, and

delirium also nearly tripled the likelihood.

Significant association of three psychiatric symptoms:  sleep disturbance, delirium and psychosis, and one neurologic feature namely movement disorders, were seen in children with confirmed anti-NMDAR encephalitis. Hence, index of suspicion for likely anti-NMDAR encephalitis should be raised early in children suspected with encephalitis presenting with these neuropsychiatric features