title: Successful treatment of anti-NMDA receptor encephalitis with a prompt ovarian tumour removal and prolonged course of plasmapheresis: A case report.
abstract: Anti-N-methyl-d-aspartate-receptor (NMDAR) encephalitis is an uncommon autoimmune disorder with a wide spectrum of neuropsychiatric symptoms. There is a great requirement to emphasize the importance of a multidisciplinary team approach in the process of diagnosis and treatment of the potentially fatal condition, including psychiatrists, neurologists, gynaecologists and intensivists. Physicians must be aware that psychiatric and neurological disorders, which are typical features for NMDAR encephalitis in young women with ovarian tumours, may progress into status epilepticus and respiratory insufficiency. This disease can only be successfully treated with prompt surgical intervention and an early implementation of a wide array of immunosuppressive therapies. Optimal timing of initiation of therapeutic plasma exchange, as well as duration of treatment necessary to achieve desirable outcomes in patients with NMDAR remains unknown. The present case report aims to raise awareness about the importance of early implementation of this potentially life-saving therapy and continuing the treatment courses until full subsidence of symptoms.
authors.affiliation: The Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Rypulak
authors.affiliation: The Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Borys
authors.affiliation: The Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
authors.forename: Pawel
authors.initials: P
authors.lastname: Piwowarczyk
authors.affiliation: The Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Fijalkowska
authors.affiliation: The Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Potrec
authors.affiliation: The Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
authors.forename: Justyna
authors.initials: J
authors.lastname: Sysiak
authors.affiliation: Department of Neurology, Neuropsychiatric Hospital, Lublin, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Spustek
authors.affiliation: Department of Paediatric Anaesthesiology and Intensive Therapy, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Bartkowska-Sniatkowska
authors.affiliation: Department of Gynaecological Oncology and Gynaecology, Medical University of Lublin, Lublin, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Kotarski
authors.affiliation: Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Lublin, Poland.
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Turski
authors.affiliation: Department of Neurology, Medical University of Lublin, Lublin, Poland.
authors.forename: Konrad
authors.initials: K
authors.lastname: Rejdak
authors.affiliation: The Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Czuczwar
keywords: EEG abnormalities; anti-NMDA receptor antibodies; autoimmune encephalitis; status epilepticus; therapeutic plasma exchange