title: Not hysteria: ovarian teratoma-associated anti-N-methyl-D-aspartate receptor encephalitis.
abstract: We report a case of a 33-year-old nulliparous woman who, following a short prodromal illness, experienced a series of psychiatric and behavioural symptoms. These included states of terror, insomnia, delirium, self-harm and suicidal ideation, facial dyskinesias, verbigeration, cognitive impairment, reduced responsiveness, violence and paranoia. A diagnosis of anti-N-methyl-d-aspartate (NMDAR) encephalitis was made 50 days after symptom onset. Early tumour removal is associated with an improved prognosis and a laparoscopic oophorectomy was performed following detection of a dermoid cyst. Within 24 hours of the operation there was marked improvement in cognitive function and appetite.
authors.affiliation: Ninewells Hospital, Dundee, Scotland, UK. rachelroberts2@nhs.net
authors.forename: R
authors.initials: R
authors.lastname: Roberts
authors.forename: N J J
authors.initials: NJ
authors.lastname: MacDougall
authors.forename: P
authors.initials: P
authors.lastname: O'Brien
authors.forename: K
authors.initials: K
authors.lastname: Abdelaziz
authors.forename: J
authors.initials: J
authors.lastname: Christie
authors.forename: R
authors.initials: R
authors.lastname: Swingler
mesh_terms: D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D001323:Autoantibodies / Q000302:isolation & purification*; D003072:Cognition Disorders / Q000209:etiology; D003884:Dermoid Cyst / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D020820:Dyskinesias / Q000209:etiology; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008775:Methylprednisolone / Q000008:administration & dosage*; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D010052:Ovariectomy / Q000379:methods; D010554:Personality Disorders / Q000209:etiology; D011239:Prednisolone / Q000008:administration & dosage; D016194:Receptors, N-Methyl-D-Aspartate / Q000302:isolation & purification*; D012893:Sleep Wake Disorders / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D016194:Receptors, N-Methyl-D-Aspartate; D011239:Prednisolone; D008775:Methylprednisolone