Asymmetric Bilateral Medial Temporal Lobe Encephalitis Associated With Anti-N-Methyl-D-Aspartate (NMDA) Receptor Antibodies: A Case Report.

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a rare autoimmune disorder that typically presents with neuropsychiatric symptoms and medial temporal lobe involvement. We report the case of a 24-year-old female with no significant medical history, who developed severe anxiety, memory deficits, and confusion over a two-week period. Neurological examination revealed cognitive dysfunction, asymmetric limb movements, and psychosis. MRI showed bilateral medial temporal lobe hyperintensities, more pronounced on the left, and CSF analysis confirmed elevated protein levels and positive anti-NMDA receptor antibodies. Treatment with high-dose corticosteroids and intravenous immunoglobulin led to significant improvement within three weeks, with a follow-up MRI showing a reduction in lesion size. This case underscores the importance of early diagnosis, particularly when atypical presentations, such as asymmetric temporal lobe involvement, are observed. Awareness of this condition, especially in young women, is critical for timely intervention and management, given its potential association with ovarian teratomas.