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Anti–N-methyl-D-aspartate Receptor Encephalitis:  Characteristic Behavioral And Movement Disorder

Simona Ferioli, MD; Josep Dalmau, MD; Christopher A. Kobet, MD; Qihui Jim Zhai, MD; Joseph P. Broderick, MD; Alberto J. Espay, MD, MSc
Arch Neurol. 2010;67(2):250-251. doi:10.1001/archneurol.2009.317.
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Anti–N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is a treatable paraneoplastic disorder predominantly affecting young women. It is characterized by a combination of psychotic encephalopathy, seizures, and abnormal movements of the trunk and face, particularly in the form of jaw dystonia. Enhanced awareness of the typical presentation can increase the index of suspicion and facilitate initiation of appropriate treatment.

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Figure 1.

Jaw-opening dystonia (A) and opisthotonic posture (B) are observed. C, A fluid-attenuated inversion recovery sequence of an axial brain magnetic resonance image shows symmetric hyperintensities in the cerebellar hemispheres (arrows).

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Figure 2.

Imaging and histopathological findings. A, A T1-weighted magnetic resonance image of the pelvis shows a 9-mm high-signal mass in the right ovary, suggestive of a small teratoma (arrow). B, Hematoxylin-eosin staining of the ovarian mass demonstrates typical mature components including benign cartilage, smooth muscle, and a cluster of ganglion cells with prominent nucleoli (arrow), confirming the diagnosis of teratoma.

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