A 54-year-old woman presented with complex partial seizure with impaired consciousness. Brain MRI revealed a high intensity lesion on T 2-weighted and FLAIR images in the left temporal lobe, indicating limbic encephalitis. CT and MRI of the pelvis showed right ovarian teratoma. The cerebrospinal fluid (CSF) were positive for antibodies against the GluRε 2, GluRδ 2, and antibodies against NR1 + NR2B heteromers. On the basis of these data, anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis associated with ovarian teratoma was suspected, and the right ovariectomy was performed. Six months after onset, brain biopsy from the right temporal lobe led to a diagnosed of glioblastoma. This is the first glioblastoma case with ovarian teratoma having autoantibodies against GluR and NR1 + NR2B heteromers in CSF. We suggest that patients with NMDAR antibodies should be carefully diagnosed with anti-NMDAR encephalitis.
- Anti-N-methyl-D-aspartate receptor antibody
- Limbic encephalitis
- Ovarian teratoma
ASJC Scopus subject areas
- Clinical Neurology