Anti-N-methyl-D-aspartate receptor encephalitis during pregnancy

Abstract

Objective: To report 3 patients who developed anti-N-methyl-d-aspartate receptor encephalitis during pregnancy.

Design: Case reports.

Setting: University hospitals. Patients Three young women developed at 14, 8, and 17 weeks of gestation acute change of behavior, prominent psychiatric symptoms, progressive decrease of consciousness, seizures, dyskinesias, and autonomic dysfunction.

Main outcome measures: Clinical, radiological, and immunological findings.

Results: The 3 patients had cerebrospinal fluid pleocytosis, normal magnetic resonance imaging, and electroencephalogram showing slow activity. All had higher antibody titers in cerebrospinal fluid than in serum and 2 had ovarian teratomas that were removed. The pregnancy was terminated in 1 patient with recurrent bilateral teratomas. All patients had substantial neurological recoveries, and the 2 newborns were normal. Results of extensive antibody testing in 1 of the babies were negative.

Conclusion: The current study shows that anti-NMDAR encephalitis during pregnancy can have a good outcome for the mother and newborn.