A case of reversible anti-NMDA-receptor encephalitis: neuropsychological and neuroradiological features

Neurol Sci. 2017 Dec;38(12):2231-2236. doi: 10.1007/s10072-017-3105-4. Epub 2017 Sep 13.

Abstract

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune encephalitis mainly affecting young women. We report a case of a mild paraneoplastic anti-NMDAR encephalitis in a 31-year-old female with an ovarian immature teratoma. The patient exhibited a severe short-term episodic memory impairment and psychiatric symptoms. A detailed diagnostic work-up including complete clinical and laboratory examinations, neuropsychological assessments, and neuroradiological investigations has been done at the onset and during follow-up. The amnestic syndrome and MRI medial-temporal abnormalities reversed after medical and surgical treatment. The present report indicates that the disease can be rapidly reversible if promptly diagnosed and treated. While the disease has already been described elsewhere, the course of neurospychological deficits in adults is not as much known. Usually, when the diagnosis of anti-NMDAR encephalitis is made, the severity of the disease makes the assessment of the neuropsycological profile particulary challenging. The present report is of interest because it describes the complete neuropsychological profile of a mild form of anti-NMDAR encephalitis.

Keywords: Amnestic syndrome; Anti-NMDA-receptor; Encephalitis; Hippocampus; Ovarian teratoma.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / diagnostic imaging*
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / psychology*
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis / therapy
  • Brain / diagnostic imaging*
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Neuropsychological Tests
  • Ovarian Neoplasms / diagnostic imaging
  • Ovarian Neoplasms / psychology
  • Ovarian Neoplasms / surgery
  • Teratoma / diagnostic imaging
  • Teratoma / psychology
  • Teratoma / surgery
  • Treatment Outcome

Supplementary concepts

  • Teratoma, Ovarian