Journal
INTERNAL MEDICINE
Volume 62, Issue 12, Pages 1817-1820Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.0447-22
Keywords
anti-NMDAR encephalitis; Bickerstaff's encephalitis; ovarian teratoma; seronegative
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Two cases of encephalitis with symptoms similar to NMDAR encephalitis but negative for anti-NMDAR antibodies were reported. The patients showed clinical improvement and good prognosis after ovarian teratoma resection and immunotherapy, indicating a close association between encephalitis and ovarian teratoma.
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder sometimes accompanied by ovarian teratoma. However, the concept of encephalitis without anti-NMDAR antibodies successfully treated with ovarian teratoma resection and immunotherapy has not been established. We herein report two such cases. Case 1 exhibited delayed magnetic resonance imaging abnormalities in the thalamus and basal ganglia, despite clinical improvement. Case 2 presented with brainstem encephalitis similar to Bickerstaff's encephalitis. Although both patients tested negative for anti-NMDAR antibodies, the recovery of the neurological function and good prognosis following tumor resection with immunotherapy indicated a close association between these diseases and ovarian teratoma.
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