title: Brain on fire: anti-N-methyl-D-aspartate-receptor encephalitis associated with ovarian teratoma.
abstract: BACKGROUND
  Anti-N-methyl-D-aspartate-receptor (anti-NMDAR) encephalitis is the most common antibody-defined autoimmune neuronal disorder. It may present with psychiatric symptoms, decreased consciousness, and hypoventilation.
  
  
  METHODS
  A 33-year old female presented with agitation and psychotic symptoms following a flu-like illness. She was treated for a presumed psychiatric disorder before she developed seizures and respiratory failure. An extensive workup including routine blood work, brain imagining, electroencephalography, and cerebrospinal fluid analysis was unremarkable. After a prolonged hospital stay requiring multiple antiepileptic drugs and sedatives, a computerized tomography of the abdomen revealed an ovarian tumor. Immunosuppressive therapy was initiated and the tumor was resected, when anti-NMDAR encephalitis was suspected. The diagnosis was confirmed following a positive anti-NMDAR antibody.
  
  
  CONCLUSIONS
  Anti-NMDAR encephalitis should be considered in the differential diagnosis of a diverse array of conditions. This case report emphasizes the importance of investigating such patients since proper treatment could potentially prevent neurologic complications or death.
authors.affiliation: Department of Internal Medicine, University of Connecticut School of Medicine, Farmington, USA. smaraka@resident.uchc.edu
authors.forename: Spyridoula
authors.initials: S
authors.lastname: Maraka
authors.forename: Chinthaka P
authors.initials: CP
authors.lastname: Bulathsinghala
authors.forename: Prasant
authors.initials: P
authors.lastname: Grover
mesh_terms: D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D013724:Teratoma / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy