Which autoimmune encephalitis is associated with ovarian teratoma and presents with psychiatric symptoms, seizures, and dyskinesias?

Which autoimmune encephalitis is associated with ovarian teratoma and presents with psychiatric symptoms, seizures, and dyskinesias?

• A. Anti-Hu (ANNA-1) encephalitis
• B. Anti-NMDA receptor encephalitis
• C. Anti-GABA-B receptor encephalitis
• D. Anti-LGI1 encephalitis

Answer: (B)

Autoimmune encephalitis caused by antibodies to the NMDA receptor is classically linked to ovarian teratomas in young women and presents with a psychiatric onset followed by seizures and movement abnormalities such as dyskinesias. The antibodies target the NR1 subunit of the NMDA receptor, causing receptor internalization and reduced NMDA receptor function. This disruption of NMDA signaling in limbic and cortical networks underlies the prominent psychiatric symptoms, cognitive changes, seizures, and dyskinesias seen in this condition. Treating the underlying teratoma plus immunotherapy improves outcomes. Other autoimmune encephalitides have different cancer associations and typical clinical features (for example, anti-Hu with SCLC; anti-GABA-B receptor encephalitis often with seizures in older adults and SCLC; anti-LGI1 with limbic encephalitis and faciobrachial dystonic seizures in older men), making the link to ovarian teratoma and the described symptom cluster characteristic of NMDA receptor encephalitis.

Autoimmune encephalitis caused by antibodies to the NMDA receptor is classically linked to ovarian teratomas in young women and presents with a psychiatric onset followed by seizures and movement abnormalities such as dyskinesias. The antibodies target the NR1 subunit of the NMDA receptor, causing receptor internalization and reduced NMDA receptor function. This disruption of NMDA signaling in limbic and cortical networks underlies the prominent psychiatric symptoms, cognitive changes, seizures, and dyskinesias seen in this condition. Treating the underlying teratoma plus immunotherapy improves outcomes. Other autoimmune encephalitides have different cancer associations and typical clinical features (for example, anti-Hu with SCLC; anti-GABA-B receptor encephalitis often with seizures in older adults and SCLC; anti-LGI1 with limbic encephalitis and faciobrachial dystonic seizures in older men), making the link to ovarian teratoma and the described symptom cluster characteristic of NMDA receptor encephalitis.