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Not hysteria: ovarian teratoma-associated anti-N-methyl-D-aspartate receptor encephalitis

R Roberts1, N J J MacDougall, P O'Brien

  • 1Ninewells Hospital, Dundee, Scotland, UK. rachelroberts2@nhs.net

Scottish Medical Journal
|August 4, 2012
PubMed

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.

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