Journal of Obstetrics and Gynaecology | 2019
Two cases of anti-N-methyl-d-aspartate-receptor encephalitis associated with ovarian teratoma
Abstract
A 21-year-old unmarried woman was admitted to our neurology department because of severe headache that lasted for the past 10 days and persistent incoherent speech, repeated seizures lasting for a few seconds. Blood and urine cultures revealed no findings of bacteria or other microorganisms. An electoencephalography (EEG) analysis revealed abnormal findings (Figure 1(A)), while brain computed tomography (CT) and magnetic resonance imaging (MRI) scans demonstrated no apparent signs. At abdominal CT imaging, a right ovarian teratoma was detected. Antidepressants, anti-anxiety drug, anticonvulsants, antiviral drug, antipsychotics, vitamin B1 and steroids were used. Laparoscopic right salpingo-oophorectomy was done. Biopsy showed a teratoma. On the fourth day after operation, she was able to perform assigned commands. She intermittently showed psychiatric symptoms, but a clinically stable condition was shown from the 14th day after operation. An EEG was performed at the second month and the EEG results were normal (Figure 1(B)).