NMDAR Encephalitis: A Rare Presentation with Bilateral Dermoid Cysts


Zahra Azeem* and Evangelia Bakali

The NMDA receptor is a protein in the brain that helps control thoughts, mood and movements and therefore antibodies against NMDA receptors are likely to have an important role in altering these functions. About 1% of dermoid cysts present with neurological symptoms. This is the case of a young girl was admitted in Critical Care with encephalitis of unknown aetiology and was extensively investigated for the cause. She was found to have small bilateral dermoid cysts following the removal of which she had prompt recovery.

Anti-NMDAR encephalitis is a serious, potentially fatal condition that is often initially confused with schizophrenia spectrum mental illness which leads to inevitable delays in diagnosis and management. Thinking out of the box and involving MDT is the key to management in more complex and rare cases. Dermoid cysts or mature ovarian teratomas should be the first differential in young women presenting with NMDAR encephalitis.




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