Can a teratoma cause encephalitis?

Anti-NMDA-receptor encephalitis is a paraneoplastic syndrome caused by teratomas. The syndrome includes psychiatric symptoms followed by autonomic dysregulation. Rapid diagnosis and removal of the tumor is essential for optimizing outcomes.

What is ovarian teratoma encephalitis?

10.1016/S1474-4422(10)70253-2. [ Nokura K, Yamamoto H, Okawara Y, Koga H, Osawa H, Sakai K. Reversible limbic encephalitis caused by ovarian teratoma. Acta Neurol Scand. 1997;95(6):367-73.

What is teratoma and encephalitis?

Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a paraneoplastic syndrome associated with ovarian teratomas; patients typically present with prominent psychiatric symptoms, seizures, and involuntary movements and rapidly progress to unresponsiveness with central hypoventilation and dysautonomia.

What are the symptoms of ovarian teratoma?

Ovarian teratoma When symptoms are present, they may include abdominal pain, mass or swelling, and abnormal uterine bleeding. Bladder symptoms, gastrointestinal disturbances, and back pain are less frequent. When abdominal pain is present, it usually is constant and ranges from slight to moderate in intensity.

How is autoimmune encephalitis treated?

Treatment of autoimmune encephalitides includes immunotherapy, either corticosteroids or intravenous immunoglobulins (IVIG). When the condition is thought to be due to a cell-surface or synaptic protein antibody, IVIG, corticosteroids or plasmapheresis are initiated in various sequences and combinations.

Can you fully recover from autoimmune encephalitis?

Many research studies show that patients continue to improve 18 months to 2 years after starting treatment. Some people with AE will recover fully, others will have mild ongoing problems, and some will be left with marked, ongoing, life-changing problems. Recovery involves both physical and mental rehabilitation.

Do ovarian teratomas need to be removed?

Ovarian teratoma Although malignant degeneration is quite rare, the cyst should be removed in its entirety, and if immature elements are found, the patient should undergo a standard staging procedure.

How is encephalitis diagnosed in ovarian teratoma?

In many cases of encephalitis due to an ovarian teratoma, diagnosis is made by history, as well as physical examination consistent with: limbic encephalitis. imaging studies that show encephalitis. negative test results for viral, bacterial, and toxicologic causes of encephalitis.

Which receptors are expressed in ovarian teratoma?

Tissue in the teratoma expresses the NMDA receptor.7. In the syndrome of ovarian teratoma and encephalitis, elevated titers of anti-NMDAR antibodies are often present in serum and CSF. The areas of the brain affected by the encephalitis, including limbic and forebrain structures, express the NMDA receptor.

Which lab findings are characteristic of teratoma-induced encephalitis?

Earlier in the afternoon serum and CSF sent to a reference laboratory returned positive for anti–N-methyl-D-aspartate (anti-NMDA)–receptor antibodies. Emergency pelvic ultrasonography was obtained, showing a 4-cm complex ovarian mass consistent with a teratoma. Based on these findings, the neurologist diagnosed teratoma-induced encephalitis.

Which areas of the brain are affected by encephalitis?

The areas of the brain affected by the encephalitis, including limbic and forebrain structures, express the NMDA receptor. Interventions that reduce levels of the anti-NMDAR antibody titer, including removal of the teratoma or immunotherapy, are often associated with a marked improvement in the clinical syndrome.