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Anti–NMDAR encephalitis complicating pregnancy
  1. Sabrina Kalam,
  2. Aravindhan Baheerathan,
  3. Cillian McNamara,
  4. Victoria Singh-Curry
  1. Department of Neurology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Dr Victoria Singh-Curry, Department of Neurology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London W6 8RF, UK; v.singh-curry{at}nhs.net

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis was first reported in 2005 in four patients with ovarian teratomas; there have been many further cases reported since the antigen for the NMDAR antibody was confirmed in 2007. Patients characteristically have a well-defined set of features, characterised by psychiatric disturbance, seizures and cognitive disturbance, followed by movement disorders, disorders of consciousness and dysautonomia. To date, 14 cases of NMDAR encephalitis have been described in the context of pregnancy. We report a case of NMDAR encephalitis in a 34-year-old woman at 8 weeks’ gestation. She had a turbulent clinical course and was initially admitted to a psychiatric unit. She was successfully treated with first-line immunomodulatory therapies and surgical resection of an ovarian teratoma. Following discharge she delivered a healthy baby and made a complete clinical recovery.

  • psychiatry
  • obstetrics
  • epilepsy
  • neuroimmunology
  • NMDA

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Footnotes

  • Contributors SK, AB and VS-C: manuscript preparation and review. CM: preparation of the figure and manuscript review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned. Externally peer reviewed by Mike Zandi, London, UK.

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