Background:
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an immune-mediated disorder characterized by a complex neuropsychiatric syndrome and the presence of antibodies against the GluN1 subunit of the NMDAR. The association between ovarian teratoma and anti-NMDAR encephalitis represents a serious, potentially life-threatening condition—particularly in young women—that is frequently overlooked during diagnosis.
Case Presentation:
We report the case of a previously healthy 19-year-old woman who presented with subacute behavioral changes, confusion, and catatonia. Upon admission, she exhibited mutism and psychomotor disturbances. Cerebrospinal fluid analysis revealed anti-NMDAR antibodies, and tumor screening identified an ovarian mass.
Intervention and Outcome:
The patient was treated with high-dose corticosteroids, plasma exchange, and antiepileptic drugs, followed by surgical resection of the ovarian mass. She was discharged in stable condition with significant improvement in neurological symptoms.
Conclusion:
This case highlights the importance of early recognition and comprehensive differential diagnosis in patients presenting with acute or subacute onset of psychiatric and behavioral symptoms. Furthermore, screening for and treating underlying tumors in cases of autoimmune encephalitis is essential, as timely surgical resection can significantly improve both short- and long-term prognoses.
N-METHYL-D-ASPARTATE RECEPTOR (NMDAR) ENCEPHALITIS ASSOCIATED WITH OVARIAN TERATOMA IN YOUNG WOMEN: A CASE REPORT
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Keywords
Anti-NMDA receptor encephalitis, behavioral changes, ovarian teratoma.
Abstract
References
[1]
Samanta D, Lui F. Anti-NMDAR Encephalitis, StatPearls, StatPearls Publishing Copyright© 2024. 2024;
Google Scholar
[2]
Acién P, Acién M, Ruiz-Maciá E, Martín-Estefanía C. Ovarian teratoma-associated anti-NMDAR encephalitis: a systematic review of reported cases. Orphanet J Rare Dis. Oct 14 2014;9:157. doi:10.1186/s13023-014-0157-x
Google Scholar
[3]
Wu CY, Wu JD, Chen CC. The Association of Ovarian Teratoma and Anti-N-Methyl-D-Aspartate Receptor Encephalitis: An Updated Integrative Review. Int J Mol Sci. Oct 9 2021;22(20)doi:10.3390/ijms222010911
Google Scholar
[4]
Nosadini M, Thomas T, Eyre M, et al. International Consensus Recommendations for the Treatment of Pediatric NMDAR Antibody Encephalitis. Neurol Neuroimmunol Neuroinflamm. Jul 2021;8(5)doi:10.1212/nxi.0000000000001052
Google Scholar
[5]
Li JH, Milla SS, Gombolay GY. Rate of Anti-NMDA Receptor Encephalitis in Ovarian Teratomas. Neuropediatrics. Apr 2022;53(2):133-135. doi:10.1055/s-0041-1740352
Google Scholar
[6]
Banach W, Banach P, Szweda H, et al. Ovarian teratoma-associated Anti-NMDAR encephalitis in women with first-time neuropsychiatric symptoms: A meta-analysis and systematic review of reported cases. Heliyon. Oct 15 2024;10(19):e36042. doi:10.1016/j.heliyon.2024.e36042
Google Scholar
[7]
Nguyen L, Wang C. Anti-NMDA Receptor Autoimmune Encephalitis: Diagnosis and Management Strategies. Int J Gen Med. 2023;16:7-21. doi:10.2147/ijgm.S397429
Google Scholar
[8]
Titulaer MJ, McCracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013;12(2):157-165. doi:10.1016/S1474-4422(12)70310-1
Google Scholar