Clinical analysis of anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma
Objective To analyse the clinical features,diagnosis,treatment and prognosis of anti-N-methyl-D-aspartic acid receptor(NMDAR)encephalitis associated with ovarian mature teratomas.Methods The clinical data of 11 patients with anti-NM-DAR encephalitis associated with ovarian teratoma from May 2014 to October 2022 were retrospectively analyzed.Results The mean age of the patients was 22.40±2.89 years(range,14-34 years).Six patients had premonitory fever symptoms,eight patients had clinical manifestations of mental disorder,and nine patients had convulsions,with varying degrees of involuntary movement.Brain MRI and electroencephalography lacked specificity.Detection of cerebrospinal fluid and serum NMD AR antibodies is the key to diagnosis.All patients experienced good outcomes in response to immunotherapy combined with ovarian tumour resection.The MRS value of all patients decreased significantly within 7 months after surgery,and one ovarian tumor relapses were reported and one encephalitis re-lapsed 11 months later.Conclusion Anti-NMDA encephalitis caused by ovarian teratoma is mostly a non-specific clinical manifes-tation of neurological and mental abnormalities,which can be easily misdiagnosed and delayed,and doctors should fully understand the disease,implement early diagnosis and timely surgical intervention to improve the prognosis of patients.
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