Sameshima Azusa, Hidaka Takao, Shima Tomoko, Nakashima Akitoshi, Hasegawa Toru, Saito Shigeru
Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.
J Obstet Gynaecol Res. 2011 Dec;37(12):1883-6. doi: 10.1111/j.1447-0756.2011.01671.x. Epub 2011 Oct 14.
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a treatment-responsive encephalitis associated with anti-NMDAR antibodies. Unlike classic paraneoplastic encephalitis, this disorder usually develops in young women with ovarian teratoma who typically present with marked neuropsychiatric symptoms, followed by prolonged respiratory failure, clouding of consciousness, and bizarre dyskinesia. This disorder is often treatable by resection of ovarian tumor and immunotherapy, but, delayed diagnosis results in a worse condition and sometimes fatal outcome. However, some gynecologists are not familiar with this disorder. When physicians encounter a female patient with encephalitis showing marked neuropsychiatric symptoms, search for an ovarian tumor should be promptly initiated. We present a case of anti-NMDAR encephalitis associated with ovarian immature teratoma. The symptoms were dramatically relieved by tumor resection and immunotherapy.
抗 N-甲基-D-天冬氨酸受体（抗 NMDAR）脑炎是一种与抗 NMDAR 抗体相关的可治疗性脑炎。与经典的副肿瘤性脑炎不同，这种疾病通常发生在患有卵巢畸胎瘤的年轻女性中，这些女性通常表现出明显的神经精神症状，随后出现长期呼吸衰竭、意识模糊和怪异的运动障碍。这种疾病通常可通过切除卵巢肿瘤和免疫治疗来治愈，但延迟诊断会导致病情恶化，有时甚至会致命。然而，一些妇科医生对这种疾病并不熟悉。当医生遇到患有脑炎且表现出明显神经精神症状的女性患者时，应立即开始寻找卵巢肿瘤。我们报告一例与卵巢未成熟畸胎瘤相关的抗 NMDAR 脑炎病例。通过肿瘤切除和免疫治疗，症状得到了显著缓解。
