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Anti-NMDAR limbic encephalitis--a clinical curiosity
Abhay K Kattepur, Darshan Patil, Amarendra Shankarappa
1Department of Surgical Oncology, Anesthesia* and Critical Care, HCG Bangalore Institute of Oncology, No 44-45/2, 2nd cross, Bangalore 560027, Karnataka, India. drgopinath1@hotmail.com.
Paraneoplastic limbic encephalitis, a rare neurological condition, can be an early sign of ovarian tumors. Early evaluation of ovarian tumors is crucial in young women with new psychiatric symptoms.
Area of Science:
- Neurology
- Oncology
- Immunology
Background:
- Neurological paraneoplastic syndromes are uncommon initial cancer indicators, necessitating high diagnostic suspicion.
- Paraneoplastic limbic encephalitis is linked to various cancers, including lung, testicular, breast, and ovarian tumors.
- This case highlights paraneoplastic limbic encephalitis associated with an ovarian tumor.
Observation:
- A 36-year-old female exhibited psychiatric symptoms including behavioral changes, mood swings, and delusions.
- Medical evaluation revealed an underlying ovarian tumor as the cause of her psychiatric manifestations.
- High anti-NMDA receptor antibody titers were detected in the patient.
Findings:
- Surgical removal of the ovarian tumor (oophorectomy) led to significant improvement in the patient's psychiatric symptoms.
- Ovarian tumors, particularly teratomas, are implicated in the development of paraneoplastic limbic encephalitis.
- Positive anti-NMDA receptor titers correlate with this condition.
Implications:
- Ovarian tumors should be considered in the differential diagnosis of young women presenting with acute psychiatric symptoms.
- Prompt diagnosis and treatment of the underlying ovarian tumor can lead to recovery from paraneoplastic limbic encephalitis.
- This case underscores the importance of a multidisciplinary approach in managing paraneoplastic syndromes.
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