Anti-NMDA receptor encephalitis

Question 1

Anti NMDA receptor encephalitis is a paraneoplastic syndrome most associated with which tumour type?

Answer 1

ovarian teratomas

• detected in 50% female patients, prevalent in Afro-Caribbean patients.

Question 2

How do patients present?

Answer 2

agitation
hallucinations
delusions
seizures
insomnia
dyskinesias
autonomic instability

Question 3

Findings on MRI head?

Answer 3

• can be normal
• some abnormalities visualised on FLAIR sequences in the deep subcortical limbic structures

Question 4

CSF findings

Answer 4

pleocytosis

Question 5

Treatment

Answer 5

IV steroids
IV Ig
rituximab
cyclophosphamide
plasma exchange

Resection of teratoma is also therapeutic.