Seizures and Ovarian Teratoma: Autoimmune Encephalitis? A Case Report
DOI:
https://doi.org/10.35381/s.v.v10i2.5244Keywords:
Encephalitis, teratoma, case reports, (Source: DeCS).Abstract
Autoimmune encephalitis can cause behavioral and cognitive changes as well as epileptic seizures. The form associated with antibodies against the N-methyl-D-aspartate (NMDAR) receptor primarily affects young people. The objective was to analyze the case of a young female patient with early-onset epilepsy who presented with a severe exacerbation of her seizure pattern, behavioral changes, and the concomitant finding of an ovarian teratoma. An analysis was conducted of a clinical case report using an analytical and evolutionary approach, prepared in accordance with the CARE (CAse REport) guidelines for the systematic and transparent reporting of clinical evidence. Results: Confirmation of the tumor does not replace the neurological criteria. A definitive anti-NMDAR diagnosis requires IgG antibodies against the GluN1 subunit of the receptor, which were not detected in this case. Conclusions: The coexistence of an exacerbated epileptic syndrome and an ovarian teratoma in a young patient should raise clinical suspicion of autoimmune encephalitis
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Dalmau J, Graus F. Antibody-mediated encephalitis. N Engl J Med. 2018;378(9):840-851. https://doi.org/10.1056/NEJMra1708712.
Dalmau J, Armangué T, Planagumà J, Radosevic M, Mannara F, Leypoldt F, et al. An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: mechanisms and models. Lancet Neurol. 2019;18(11):1045-1057. https://n9.cl/cremf.
Dalmau J, Tüzün E, Wu HY, Masjuan J, Rossi JE, Voloschin A, et al. Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol. 2007;61(1):25-36. https://n9.cl/u9chsr.
Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T, et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016;15(4):391-404. https://doi.org/10.1016/S1474-4422(15)00401-9.
Dalmau J, Graus F. Diagnostic criteria for autoimmune encephalitis: utility and pitfalls for antibody-negative disease. Lancet Neurol. 2023;22(6):529-540. https://pubmed.ncbi.nlm.nih.gov/37210100/.
Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D; CARE Group. The CARE guidelines: consensus-based clinical case reporting guideline development. J Med Case Rep. 2013;7:223. https://doi.org/10.1186/1752-1947-7-223.
Marrodan M, Perez Arana CI, Kirchner RJ, Varela FJ, Orzuza GI, Schteinschnaider A, et al. Anti-NMDAR encephalitis across the lifespan: clinical, electrophysiological, and prognostic insights from a Latin American cohort. J Neuroimmunol. 2025;409:578766. https://n9.cl/a9sisf.
Gresa-Arribas N, Titulaer MJ, Torrents A, Aguilar E, McCracken L, Leypoldt F, et al. Antibody titres at diagnosis and during follow-up of anti-NMDA receptor encephalitis: a retrospective study. Lancet Neurol. 2014;13(2):167-177. https://doi.org/10.1016/S1474-4422(13)70282-5.
Titulaer MJ, McCracken L, Gabilondo I, Armangué T, Glaser C, Iizuka T, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013;12(2):157-165. https://doi.org/10.1016/S1474-4422(12)70310-1.
Abboud H, Probasco JC, Irani S, Ances B, Benavides DR, Bradshaw M, et al. Autoimmune encephalitis: proposed best practice recommendations for diagnosis and acute management. J Neurol Neurosurg Psychiatry. 2021;92(7):757-768. https://doi.org/10.1136/jnnp-2020-325300.
Dutra LA, Silva PVC, Ferreira JHF, Marques AC, Toso FF, Vasconcelos CCF, et al. Brazilian consensus recommendations on the diagnosis and treatment of autoimmune encephalitis in the adult and pediatric populations. Arq Neuropsiquiatr. 2024;82(7):1-15. https://n9.cl/mbvgn.
Hoshina Y, Smith TL, Delic A, Wong KH, Peterson LK, Zekeridou A, et al. An updated, comprehensive meta-analysis of the treatment of anti-NMDAR encephalitis: analysis, equipoise, and the urgent need for evidence over anecdote. J Neuroimmunol. 2025;405:578651. https://n9.cl/slftg.
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