Neurological response to early removal of ovarian teratoma in anti-NMDAR encephalitis
Open accessAbstract
We report an 18-year-old woman with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, who developed psychiatric symptoms, progressive unresponsiveness, dyskinesias, hypoventilation, hypersalivation and seizures. Early removal of an ovarian teratoma followed by plasma exchange and corticosteroids resulted in a prompt neurological response and eventual full recovery. Serial analysis of antibodies to NR1/NR2B heteromers of the NMDAR showed an early decrease of serum titres, although the cerebrospinal fluid titres correlated better with clinical outcome. The patients' antibodies reacted with areas of the tumour that contained NMDAR-expressing tissue. Search for and removal of a teratoma should be promptly considered after the diagnosis of anti-NMDAR encephalitis.
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In a few patients whose CSF was obtained during neurological improvement, the decrease of CSF antibody titres was substantially slower than that of serum titres.
“For example, in a few patients whose CSF was obtained during neurological improvement, the decrease of CSF antibody titres was substantially slower than that of serum titres.9”
From Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies (2008) · cites this paper as [9]
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References 8 · Cited by 147
- Authors
- Seki, M., Suzuki, S., Iizuka, T., Shimizu, T., Nihei, Y., Suzuki, N., & Dalmau, J.
- Affiliations
- Keio University (JP)
- Kitasato University (JP)
- University of Pennsylvania (US)
- Corresponding author
- Suzuki, S
- Suzuki, N
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2008-03-01
- Volume
- 79
- Issue
- 3
- Pages
- 324-326
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC2574536
- OpenAlex
- W2027547809
- Cited by
- 147
- References
- 8
- Citations by year
- 2026: 4 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 6 · 2020: 3 · 2019: 6 · 2018: 6 · 2017: 7 · 2016: 7 · 2015: 9 · 2014: 5 · 2013: 12 · 2012: 12
- FWCI
- 7.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Cancer Institute (R01CA089054, R01CA89054, R01CA1071892, R01CA107192)
- Topics
- Health Sciences › Medicine › Neurology › Autoimmune Neurological Disorders and Treatments
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Health Sciences › Medicine › Neurology › Myasthenia Gravis and Thymoma
- Keywords
- anti-NMDA receptor encephalitis, ovarian teratoma, teratoma resection, plasma exchange, corticosteroids, NMDA receptor antibodies, neurological recovery, autoimmune encephalitis, seizures, unresponsiveness
- MeSH terms
- Adolescent, Adrenal Cortex Hormones, Antibodies, Encephalitis, Female, Humans, Immunohistochemistry, Ovarian Neoplasms, Plasma Exchange, Teratoma, Biomarkers, Tumor, Receptors, N-Methyl-D-Aspartate, Paraneoplastic Syndromes, Nervous System
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