Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec 20;7(24):4378-4382.
doi: 10.3889/oamjms.2019.839. eCollection 2019 Dec 30.

Treatment of Anti-NMDA Receptor Encephalitis with Ovarian Teratoma Removal: A Literature Review and Two Case Reports

Nguyen Phuong Tu  1   2 , Pham Ba Nha  1   2 , Nguyen Duy Hung  1   2 , Nguyen Hoang Minh  3 , Hoang Ngoc Anh  2 , Thien Chu Dinh  4   5
Affiliations

Treatment of Anti-NMDA Receptor Encephalitis with Ovarian Teratoma Removal: A Literature Review and Two Case Reports

Nguyen Phuong Tu et al. Open Access Maced J Med Sci. .

Abstract

Background: N-methyl-d-aspartate receptor (NMDAR) antibody encephalitis appears common in the world, but the number of clinical cases in Vietnam which were recorded is rare.

Case report: We describe two new cases of disease in recent years with the aim of contributing to diagnosis and treatment experiences. These cases were noted over the past 3 years with the patients who have been treated at lower levels but have no results. They came to us when symptoms became worse and therefore required prolonged treatment with special intensive care facilities. The atypical and easily confused symptoms are the reasons that make the disease be detected late; leading to a much higher cost of treatment and the complication may appear in the patient. In the past, patients with these manifestations were diagnosed with unexplained encephalitis and severe sequelae or death. Autoimmune encephalitis has many types; NMDA encephalitis associated with ovarian teratoma is the most common autoimmune encephalitis in young women.

Conclusion: In conclusion, based on the case report, we hope to contribute some experiences on the diagnosis and the strategy in early treatment. With most female patients at very young age, early treatment to avoid complications will help patients have a quality life and maintain reproductive function.

Keywords: Immunoglobulin; NMDA encephalitis; Ovarian teratoma.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Imaging of the ovarian teratoma on the ultrasound; A) Ovarian teratoma on the vaginal ultrasound imaging; B) Ovarian teratoma on the abdominal ultrasound imaging
Figure 2
Figure 2
Imaging of the ovarian teratoma after surgery
Figure 3
Figure 3
Imaging of the patient on MRI result; A) Imaging of a normal condition; B) Imaging did not show a condition of brain edema
Figure 4
Figure 4
Imaging of the ovarian teratoma after laparoscopic cystectomy. After surgery, the patient had recovered significantly
See this image and copyright information in PMC

References

    1. Day GS, et al. Anti-NMDA-receptor encephalitis:case report and literature review of an under-recognized condition. Journal of general internal medicine. 2011;26(7):811–816. https://doi.org/10.1007/s11606-011-1641-9 PMid:2131⇀PMCid:PMC313Ↄ. - PMC - PubMed
    1. Dalmau J, et al. Anti-NMDA-receptor encephalitis:case series and analysis of the effects of antibodies The Lancet. Neurology. 2008;7(12):1091–1098. https://doi.org/10.1016/S1474-4422(08)70224-2. - PMC - PubMed
    1. Dalmau J, et al. Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. The Lancet. Neurology. 2011;10(1):63–74. https://doi.org/10.1016/S1474-4422(10)70253-2. - PMC - PubMed
    1. Uchino A, et al. Pseudo-piano playing motions and nocturnal hypoventilation in anti-NMDA receptor encephalitis:response to prompt tumor removal and immunotherapy. Internal medicine. 2011;50(6):627–630. https://doi.org/10.2169/internalmedicine.50.4764 PMid:21422691 PMCid:PMC3740121. - PMC - PubMed
    1. Shimazaki H, et al. Reversible limbic encephalitis with antibodies against the membranes of neurones of the hippocampus. Journal of neurology, neurosurgery, and psychiatry. 2007;78(3):324–325. https://doi.org/10.1136/jnnp.2006.104513 PMid:17308294 PMCid:PMC2117656. - PMC - PubMed

LinkOut - more resources