title: Clinical analysis of paraneoplastic encephalitis associated with ovarian teratoma.
abstract: BACKGROUND
  Recently, paraneoplastic encephalitis associated with ovarian teratoma has been described and related to an autoantibody.
  
  
  METHODS
  We describe four patients with ovarian teratoma-associated encephalitis (OTE) and compared their clinical pictures with those of 17 previously reported patients with OTE.
  
  
  RESULTS
  Clinically, OTE was characterized by the development of acute prominent psychiatric symptoms (20 of 21 patients), seizures (15 of 21 patients), and central hypoventilation (13 of 21 patients). Our patients had hypersalivation (three patients) and cardiac conduction problems (all patients); hypothermia was present in one patient. The mean time from the onset of OTE to tumor diagnosis was 19.6+/-22.1 weeks. Ventilatory support was required for 54.9+/-25.4 days on average. The white blood cell count in cerebrospinal fluid was 55.1+/-61.2/mm3. Twelve patients showed abnormalities on cranial MRI, involving areas such as the temporal regions (seven patients) or brainstem (four patients). In addition to tumor resection, 17 patients received some type of immunotherapy: 17 patients received corticosteroids, 10 received intravenous immunoglobulins, two received cyclophosphamide, seven received plasma exchange. Eighteen patients with OTE had neurological improvement, including 11 with full recovery.
  
  
  CONCLUSIONS
  OTE presents with cardiac conduction problems and hypersalivation in addition to psychiatric symptoms, seizures, and central hypoventilation.
authors: Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, and Ikeda City Hospital, Osaka, Japan.
authors: Yasuyo
authors: Y
authors: Tonomura
authors: Hiroshi
authors: H
authors: Kataoka
authors: Yasuo
authors: Y
authors: Hara
authors: Miwa
authors: M
authors: Takamure
authors: Itirou
authors: I
authors: Naba
authors: Takanori
authors: T
authors: Kitauti
authors: Kozue
authors: K
authors: Saito
authors: Satoshi
authors: S
authors: Ueno
mesh_terms: D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D007040:Hypoventilation / Q000209:etiology; D008279:Magnetic Resonance Imaging; D001523:Mental Disorders / Q000209:etiology; D010051:Ovarian Neoplasms / Q000150:complications*; D020361:Paraneoplastic Syndromes, Nervous System / Q000209:etiology* / Q000503:physiopathology*; D012640:Seizures / Q000209:etiology; D012798:Sialorrhea / Q000209:etiology; D013724:Teratoma / Q000150:complications*