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.
KawanoH, HamaguchiE, KawahitoS.Anaesthesia for a patient with paraneoplastic limbic encephalitis with ovarian teratoma: relationship to anti-N-methyl-D-aspartate receptor antibodies.Anaesthesia2011; 66: 515–8.
2.
GranerodJ, AmbroseHE, DaviesNW.Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study.Lancet Infect Dis2010; 10: 835–44.
DalmauJ, LancasterE, Martinez-HernandezE.Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis.Lancet Neurol2011; 10: 63–74.
5.
DalmauJ, GleichmanA, HughesE.Anti NMDA-receptor encephalitis: case series and analysis of the effects of antibodies.Lancet Neurol2008; 7: 1091–8.
6.
IizukaT, SakaiF, IdeT.Anti NMDA receptor encephalitis in Japan: long term outcome without tumour removal.Neurology2008; 2: 504–11.
