Posters
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Medical Student
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Medical Student
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Family Medicine
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Patient Care
Abstract Type
Case Report
Abstract
Background: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune condition caused by antibodies targeting NMDA receptors in the brain. The condition was first described in association with ovarian teratomas in 2005; however, it was in 2007 that the condition was further identified as an anti-NMDA receptor-mediated encephalitis. These antibodies disrupt synaptic function by internalizing NMDA receptors, leading to a wide range of neuropsychiatric symptoms such as mood changes, seizures, and autonomic dysfunction. The incidence of autoimmune encephalitis, including anti-NMDAR variants, has increased from 0.4 to 1.2/100,000 person-years over the past two decades due to improved detection of antibody-positive cases. Although the condition primarily affects young women, pediatric cases are increasingly recognized; however, the novelty of this condition in children, in association with a nonspecific presentation, can lead to delays in diagnosis and treatment. Early intervention with tumor resection and immunotherapy significantly improves prognosis and reduces long-term complications.
Case Presentation: A 12-year-old Hispanic female presented with acute mood changes, insomnia, and a generalized tonic-clonic seizure. Initial evaluation in the emergency department resulted in a misdiagnosis of psychogenic seizures. Persistent symptoms prompted further evaluation at a major medical center. Cerebrospinal fluid analysis revealed elevated antiNMDAR antibodies, confirming the diagnosis. Pelvic ultrasound and MRI revealed a 2.1 cm dermoid cyst in the right ovary, clarifying the association. The patient underwent a laparoscopic oophorectomy, which successfully removed the teratoma. She also received high-dose corticosteroids and symptomatic management with anti-seizure medications. Post-operatively and prior to discharge, the patient's neuropsychiatric symptoms, including mood and speech disturbances, were completely resolved. At a follow-up with her primary care physician, just two months after the initial presentation of symptoms, the patient demonstrated sustained recovery with no recurrence of symptoms.
Conclusion: Anti-NMDAR encephalitis is a rare yet treatable condition that requires prompt recognition and comprehensive management. This case underscores the importance of practitioners having heightened clinical awareness of this condition and considering it in the differential diagnosis of pediatric patients with unexplained, nonspecific neuropsychiatric symptoms. The rising incidence of cases due to improved diagnostic capabilities also emphasizes the importance of clinical awareness. This case contributes to the growing body of evidence demonstrating the variability in the presentation of this condition in pediatric patients and that early intervention, including tumor removal and immunotherapy, described in this case, demonstrates that the patient can reach a complete resolution of symptoms.
Recommended Citation
Garcia, Stephen M. and Uribe MD, Eduardo, "Anti-NMDA Receptor Encephalitis Associated with Ovarian Teratoma in a Pediatric Patient: A Case Report" (2025). Research Symposium. 160.
https://scholarworks.utrgv.edu/somrs/2025/posters/160
Included in
Anti-NMDA Receptor Encephalitis Associated with Ovarian Teratoma in a Pediatric Patient: A Case Report
Background: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune condition caused by antibodies targeting NMDA receptors in the brain. The condition was first described in association with ovarian teratomas in 2005; however, it was in 2007 that the condition was further identified as an anti-NMDA receptor-mediated encephalitis. These antibodies disrupt synaptic function by internalizing NMDA receptors, leading to a wide range of neuropsychiatric symptoms such as mood changes, seizures, and autonomic dysfunction. The incidence of autoimmune encephalitis, including anti-NMDAR variants, has increased from 0.4 to 1.2/100,000 person-years over the past two decades due to improved detection of antibody-positive cases. Although the condition primarily affects young women, pediatric cases are increasingly recognized; however, the novelty of this condition in children, in association with a nonspecific presentation, can lead to delays in diagnosis and treatment. Early intervention with tumor resection and immunotherapy significantly improves prognosis and reduces long-term complications.
Case Presentation: A 12-year-old Hispanic female presented with acute mood changes, insomnia, and a generalized tonic-clonic seizure. Initial evaluation in the emergency department resulted in a misdiagnosis of psychogenic seizures. Persistent symptoms prompted further evaluation at a major medical center. Cerebrospinal fluid analysis revealed elevated antiNMDAR antibodies, confirming the diagnosis. Pelvic ultrasound and MRI revealed a 2.1 cm dermoid cyst in the right ovary, clarifying the association. The patient underwent a laparoscopic oophorectomy, which successfully removed the teratoma. She also received high-dose corticosteroids and symptomatic management with anti-seizure medications. Post-operatively and prior to discharge, the patient's neuropsychiatric symptoms, including mood and speech disturbances, were completely resolved. At a follow-up with her primary care physician, just two months after the initial presentation of symptoms, the patient demonstrated sustained recovery with no recurrence of symptoms.
Conclusion: Anti-NMDAR encephalitis is a rare yet treatable condition that requires prompt recognition and comprehensive management. This case underscores the importance of practitioners having heightened clinical awareness of this condition and considering it in the differential diagnosis of pediatric patients with unexplained, nonspecific neuropsychiatric symptoms. The rising incidence of cases due to improved diagnostic capabilities also emphasizes the importance of clinical awareness. This case contributes to the growing body of evidence demonstrating the variability in the presentation of this condition in pediatric patients and that early intervention, including tumor removal and immunotherapy, described in this case, demonstrates that the patient can reach a complete resolution of symptoms.
