Complex partial status epilepticus revealing anti-NMDA receptor encephalitis

• Published in: Epileptic disorders Vol. 11; no. 3; pp. 261 - 265
• Main Authors: Bayreuther, Caroline, Bourg, Véronique, Dellamonica, Jean, Borg, Michel, Bernardin, Gilles, Thomas, Pierre
• Format: Journal Article
• Language: English
• Published: France 01-09-2009
• Subjects: Adult; Anticonvulsants - therapeutic use; Electroencephalography; Encephalitis - complications; Encephalitis - pathology; Epilepsy, Complex Partial - drug therapy; Epilepsy, Complex Partial - etiology; Female; Humans; Limbic Encephalitis - immunology; Magnetic Resonance Imaging; Ovarian Neoplasms - pathology; Receptors, N-Methyl-D-Aspartate - immunology; Status Epilepticus - drug therapy; Status Epilepticus - etiology; Teratoma - pathology; Tomography, X-Ray Computed
• ISSN: 1294-9361; 1950-6945
• DOI: 10.1684/epd.2009.0266

Encephalitis with anti-NMDA receptor antibodies is a recently-recognised form of paraneoplastic encephalitis characterized by a prodromal phase of unspecific illness with fever resembling viral disease, followed by memory loss, psychiatric features, seizures, disturbed consciousness, prominent abnormal movements and autonomic imbalance. Association with ovarian teratoma is common. Neurological outcome can be good, especially when surgery is performed at an early stage. Here, we report a case of anti-NMDA receptor encephalitis associated with ovarian teratoma presenting with inaugural complex partial status epilepticus. The nature of abnormal movements at early stages was unclear and abnormal movements were misinterpreted as the recurrence of partial epileptic seizures. Despite its rarity, all clinicians treating epilepsy and movement disorders should be familiar with anti-NMDA receptor encephalitis, that appears to be a very severe but curable disease.