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A Simple Cell-based Immunofluorescence Assay to Detect Autoantibody Against the N-Methyl-D-Aspartate (NMDA) Receptor in Blood
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[Case report of anti-NMDA receptor encephalitis suspected of schizophrenia]

Yushi Suzuki1, Tsugiko Kurita, Kotaro Sakurai

  • 1Department of Psychiatry, Hokkaido University.

Seishin Shinkeigaku Zasshi = Psychiatria Et Neurologia Japonica
|February 9, 2010
PubMed

Insights

Anti-NMDA receptor encephalitis, often seen in young women with ovarian teratomas, presents with severe psychiatric symptoms but is treatable. Early diagnosis and treatment, including tumor removal, lead to full recovery.

Area of Science:

  • Neurology
  • Oncology
  • Psychiatry

Background:

  • Paraneoplastic encephalitis associated with ovarian teratoma predominantly affects young women.
  • This condition presents with severe, yet often reversible and treatment-responsive, symptoms.

Observation:

  • A 22-year-old female initially presented with memory loss, later developing psychiatric symptoms, seizures, and unresponsiveness.
  • Initial tests for viral encephalitis and schizophrenia were inconclusive, with normal brain imaging.
  • An abdominal CT scan revealed an ovarian teratoma, and anti-N-methyl-D-aspartate (NMDA) receptor antibodies were detected in CSF and serum.

Findings:

  • The patient was diagnosed with anti-NMDA receptor encephalitis.
  • Treatment with gamma globulin and surgical removal of the ovarian teratoma resulted in complete recovery.

Implications:

  • This case highlights the importance of considering anti-NMDA receptor encephalitis in patients with unexplained psychiatric symptoms and neurological deficits.
  • Prompt diagnosis and multidisciplinary treatment, including tumor resection, are crucial for favorable outcomes in this potentially devastating condition.

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