2025 Volume 45 Issue 7 Pages 636-639
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune disorder that is known to predominantly affect young women. Approximately half of the patients present with ovarian teratomas, and prompt oophorectomy leads to a good prognosis. We report two cases in which early suspicion of the disease and prompt surgery led to favorable recoveries. Case 1; the patient was initially admitted to the Psychiatry department for acute psychiatric symptoms followed by the development of fever and seizures. On day 19, the patient was transferred to our hospital, where computed tomography (CT) scan revealed minor calcification in the ovary suggestive of an ovarian teratoma; oophorectomy was performed. Case 2; the patient presented with fever and altered consciousness and was urgently admitted. The patient’s typical clinical course and CT-identified ovarian tumor were strongly suggestive of anti-NMDA receptor encephalitis. Prompt oophorectomy led to a good prognosis. In both patients, the diagnosis of ovarian teratoma was confirmed by histopathology, and both patients exhibited rapid postoperative improvement and full recovery without sequelae. Anti-NMDA receptor encephalitis is often misdiagnosed as a psychiatric illness. In young women presenting with acute neuropsychiatric symptoms, clinicians should consider the possible diagnosis of anti-NMDA receptor encephalitis early in the disease course, proactively investigate for ovarian teratoma, and perform timely resection where indicated.
