1. Anti-NMDAR encephalitis with ovarian teratomas: Review of the literature and two case reports
- Author
-
Yu-Ching Su, Hsiao-Chen Chiu, Pei-Shen Huang, Su-Cheng Huang, and Han-Lin Chiang
- Subjects
Adult ,Psychosis ,Pediatrics ,medicine.medical_specialty ,endocrine system ,endocrine system diseases ,medicine.medical_treatment ,Taiwan ,Immunoglobulins ,lcsh:Gynecology and obstetrics ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Ovarian Teratoma ,lcsh:RG1-991 ,Anti-N-Methyl-D-Aspartate Receptor Encephalitis ,Ovarian Neoplasms ,Coma ,Autoimmune encephalitis ,030219 obstetrics & reproductive medicine ,business.industry ,Teratoma ,Obstetrics and Gynecology ,Oophorectomy ,Dysautonomia ,Anti-NMDAR Encephalitis ,medicine.disease ,female genital diseases and pregnancy complications ,Female ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Encephalitis - Abstract
Objective: Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a paraneoplastic syndrome associated with ovarian teratomas. Anti-NMDAR encephalitis patients typically present with prominent psychiatric symptoms, seizures, and involuntary movements; further, they rapidly progress to unresponsiveness with central hypoventilation and dysautonomia. Case report: This paper presents two anti-NMDAR encephalitis cases with ovarian teratomas and reviews 13 anti-NMDAR encephalitis clinical case reports in Taiwan, of which six involved ovarian tumors, five being mature teratomas. Patients presented with acute onset of psychiatric symptoms and subsequently developed coma within a few days. Anti-NMDAR encephalitis usually occurs in young women and is often associated with ovarian tumors, specifically teratomas. Ovarian cystectomy or oophorectomy was performed, which markedly improved cognitive function. Conclusion: Paraneoplastic neurological conditions associated with ovarian teratomas represent a fascinating disease process. Identifying the gynecological cause of a neurological condition, particularly in young women, followed by prompt treatment can remarkably improve clinical conditions and, thus, be lifesaving. Keywords: Anti-N-Methyl-d-aspartate receptor (anti-NMDAR) encephalitis, Autoimmune encephalitis, Ovarian teratoma, Paraneoplastic syndrome, Psychosis more...
- Published
- 2019