Neurology Department, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
Neurology Department, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.
BMJ Case Rep. 2023 Jul 11;16(7):e250998. doi: 10.1136/bcr-2022-250998.
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune antibody encephalitis, commonly affecting young women with comorbid ovarian teratoma. It typically presents with alteration of consciousness, psychosis, movement disorders eventually deteriorating with seizures, dysautonomia and central hypoventilation requiring critical level of care that may last weeks to months. Removal of teratoma and immunosuppressant therapy support can led to a dramatic recovery.To our knowledge, this is the first illustrated case in the literature of a pregnant woman presenting with concurrent autoimmune NMDAR and anti-glial gibrillary acidic protein(GFAP) antibody encephalitis in the setting of an ovarian teratoma. Despite the teratoma removal and receiving various forms of immunosuppressant therapy, a meaningful neurological improvement was observed following the delivery. After a prolonged hospitalisation and recovery period, the patient and her offspring made an excellent recovery highlighting the significance of early diagnosis and management.
抗 N-甲基-D-天冬氨酸受体（NMDAR）脑炎是一种自身免疫性抗体脑炎，常见于伴有卵巢畸胎瘤的年轻女性。它通常表现为意识改变、精神病、运动障碍，最终伴有癫痫发作、自主神经功能障碍和中枢性低通气，需要重症监护，持续数周至数月。畸胎瘤切除和免疫抑制剂治疗支持可导致显著恢复。据我们所知，这是文献中首例在卵巢畸胎瘤的背景下，同时发生自身免疫性 NMDAR 和抗神经胶质纤维酸性蛋白（GFAP）抗体脑炎的孕妇病例。尽管切除了畸胎瘤并接受了各种形式的免疫抑制剂治疗，但在分娩后观察到了有意义的神经功能改善。经过长时间的住院和恢复，患者及其后代恢复良好，突出了早期诊断和管理的重要性。
