Document Detail


Reversible paraneoplastic encephalitis in three patients with ovarian neoplasms.
MedLine Citation:
PMID:  22390222     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is a recently described potentially lethal but treatable disorder that often occurs as a paraneoplastic manifestation of ovarian teratomas. We report three women with this disorder who presented with subacute onset of delirium, seizures and autonomic instability. Anti-NMDA receptor antibodies were detectable in the serum or cerebrospinal fluid of each patient. Ovarian masses were detected in two patients, and subsequently excised. In the third patient, an empirical bilateral salpingo-oophorectomy was performed and revealed a microscopic neoplasm. All patients experienced slow reversal of the neurological symptoms following surgery and immunotherapy. Our experience suggests that prompt syndrome recognition followed by tumor removal and immunotherapy usually results in neurological recovery.
Authors:
Janos L Tanyi; Evelyn B Marsh; Josep Dalmau; Christina S Chu
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-03-05
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  91     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-20     Completed Date:  2012-06-14     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  630-4     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Autoantibodies / blood,  cerebrospinal fluid
Female
Humans
Immunotherapy
Magnetic Resonance Imaging
Middle Aged
Ovarian Neoplasms / immunology,  pathology*
Ovariectomy
Paraneoplastic Syndromes, Nervous System / immunology,  physiopathology*,  surgery
Receptors, N-Methyl-D-Aspartate / immunology*
Salpingostomy
Teratoma / immunology,  pathology*
Tomography, X-Ray Computed
Treatment Outcome
Young Adult
Grant Support
ID/Acronym/Agency:
1RC1NS068204-01/NS/NINDS NIH HHS; 5K12HD00849-23/HD/NICHD NIH HHS; R01 CA089054/CA/NCI NIH HHS; R01 CA089054-01A1/CA/NCI NIH HHS; R01 MH094741-01/MH/NIMH NIH HHS; R01 NS077851/NS/NINDS NIH HHS; R01 NS077851-05A2/NS/NINDS NIH HHS; R01CA89054/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/Receptors, N-Methyl-D-Aspartate
Comments/Corrections

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