Anti-NMDA receptor paraneoplastic encephalitis: complete recovery after ovarian teratoma removal

作者：Reyes Botero German^*; Uribe Carlos S; Hernandez Ortiz Olga E; Ciro Juan; Guerra Alejandro; Dalmau Obrador Josep

来源：Revista de Neurologia, 2011, 52(9): 536-540.

• Encephalitis
• NMDA
• Ovarian teratoma
• Paraneoplastic syndrome

Introduction. A paraneoplastic syndrome characterized by neuropsychiatric symptoms, involuntary movements and seizures has been recently associated with antibodies targeting NMDA (N-methyl-D-aspartate) receptor in patients with an ovarian teratoma. Severe neurological impairment is frequent and treatment in the intensive care unit is often required because of ventilatory failure and life-threatening autonomic instability. Tumor removal is curative in many cases and neurological improvement is demonstrated shortly after surgery.
Case report. Here we report on a patient with paraneoplastic encephalitis manifested by unconsciousness and coreoathetosic movements related to NMDA receptor antibodies associated with an immature ovarian teratoma grade Ill. She made a complete recovery after oophorectomy, intravenous immunoglobulin and corticosteroids.
Conclusions. Treatment of paraneoplastic syndromes is based on specific therapy for underlying tumor associated to immunomodulators. As in this case, anti-NMDA encephalitis may significantly improve after tumor removal and intravenous immunoglobuline.

• 出版日期2011-5-1