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Non–N-Methyl-D-Aspartate Receptor Antibody Encephalitis With Cerebellitis With Associated Ovarian Teratoma

Andrew D. Smith III, MD1; Lawrence Samkoff, MD1
[+] Author Affiliations
1Department of Neurology, University of Rochester Medical Center, Rochester, New York
JAMA Neurol. 2015;72(11):1375-1377. doi:10.1001/jamaneurol.2015.1531.
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This case report describes a woman in her mid-20s who presented with fever, headache, encephalopathy, and ataxia.

The incidence of autoimmune and paraneoplastic encephalitis is increasing with improved recognition of clinical syndromes and diagnostic testing. Anti–N-methyl-D-aspartate receptor (NMDAR) encephalitis has been well described in young women with ovarian teratoma.1 The classic presentation of this syndrome is a subacute encephalopathy with mood disturbances, including psychosis, with variability of seizures and movement disorders. However, to our knowledge, there have been no reported associations between ovarian teratomas and paraneoplastic cerebellitis. Typically, paraneoplastic cerebellar degeneration or cerebellitis has been linked to anti-Yo antibody. More recently, cases of autoimmune and paraneoplastic cerebellitis have been reported with associated anti–Homer-3 and anti–metabotropic glutamate receptor 1 antibodies. Metabotropic glutamate receptor 1 has been associated with Hodgkin lymphoma, but there have been no reported neoplasms in cases of cerebellitis with positive Homer-3 antibodies.2,3

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Computed Tomography of the Abdomen and Pelvis

Coronal view of the abdomen and pelvis showing a right adnexal fat-containing mass with a soft tissue nodule in the wall (arrowhead).

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