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Anti-NMDAR encephalitis typically affects younger patients. In one series of 100 cases , the median age was 23 years (range, 5-76 years); over 90% were female. In that series, patients presented with psychiatric symptoms or memory disorders (100%), decreased levels of consciousness (88%), dyskinesias (86%), and seizures (76%), All had antibodies in the cerebrospinal fluid against subunits of the NMDA receptor. Since these receptors are prevalent in the limbic system and the hippocampus , patients develop signs and symptoms of limbic encephalitis : memory loss, hallucinations, irritability, agitation, sleep disturbance and seizures.
Tolerance to certain benzodiazepines occurs most often in those who have used for 6 months or more. Physicians counteract the effects of tolerance by increasing dosage in small increments or by adding another benzodiazepine to the prescription. Users most often develop tolerance to the milder effects of the drug, such as sedation and impairment of motor coordination. A fair amount of cross-tolerance exists between benzodiazepines and other depressants such as alcohol and barbiturates, thus users may not feel the effects of these drugs as potently as they would otherwise.