Atypical Presentation of Anti‐NMDAR Encephalitis in an Elderly Male With Dominated Memory Impairment From Damascus Hospital

Anti‐N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis is a rare but serious autoimmune disorder that is typically characterized by a broad spectrum of psychiatric and neurological symptoms. In the academic literature, memory deficits often occur alongside psychiatric symptoms, seizures, motor dysfunctions, and other cognitive issues; it is rare to find it dominated by memory impairment with only one previous seizure. We present a unique presentation of anti‐NMDAR encephalitis in a 70‐year‐old Middle Eastern male patient who primarily exhibited memory impairment along with one unrepeated recent seizure. The patient's initial clinical picture did not align with the classic presentation of anti‐NMDAR encephalitis, which often includes prominent psychiatric symptoms and neurological features of motor dysfunction. However, brain magnetic resonance imaging (MRI), electroencephalography (EEG), and the presence of anti‐NMDAR antibodies in the cerebrospinal fluid support the diagnosis. Physicians should be aware to consider anti‐NMDAR encephalitis in patients with memory impairment and a single previous seizure, even in the absence of typical psychiatric or neurological features.