A Case of Paraneoplastic Limbic Encephalitis Presented with Schizophrenic Symptoms.
10.4306/jknpa.2015.54.4.596
- Author:
Kyu Sik SHIN
1
;
Eun Jin CHEON
;
Se Jin LEE
Author Information
1. Department of Neurology, College of Medicine, Yeungnam University, Daegu, Korea. sejinmayo@ynu.ac.kr
- Publication Type:Case Report
- Keywords:
Limbic encephalitis;
Paraneoplastic;
Ovarian teratoma;
Schizophrenia
- MeSH:
Adult;
Amnesia;
Anti-Bacterial Agents;
Antibodies;
Brain;
Cerebrospinal Fluid;
Chorea;
Dystonia;
Female;
Fever;
Hallucinations;
Humans;
Limbic Encephalitis*;
Magnetic Resonance Imaging;
Memory;
Movement Disorders;
N-Methylaspartate;
Pelvis;
Schizophrenia;
Teratoma
- From:Journal of Korean Neuropsychiatric Association
2015;54(4):596-599
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Paraneoplastic limbic encephalitis associated with ovarian teratoma has variable clinical manifestations, including hallucination, abnormal behavior, amnesia, mental change, fever, chorea and dystonia, and often has antibodies to N-methyl-D-aspartate receptor (NMDAR), however cases without tumor or antibodies to NMDAR have also been reported. Here, we describe a 35-year-old female who was initially misdiagnosed as schizophrenia because she presented with acute onset of psychiatric symptoms, including visual hallucination, abnormal behavior, confusion, and memory impairment. Three days after admission, she developed high fever refractory to antibiotics. Brain MRI and examination of cerebrospinal fluid were normal. Computerized tomography of the pelvis showed an ovarian teratoma. The patient showed complete improvement after surgical removal of the ovarian teratoma and steroid therapy. We suggest that physicians should consider the possibility of paraneoplastic limbic encephalitis in patients who present with acute onset of psychiatric symptoms with high fever or movement disorder.
