Encephalitis associated with anti-N-Methyl-D-aspartate
(NMDA) receptor is a rare form of autoimmune encephalitis.
We report the first case of anti-NMDAR encephalitis in an
unmarried 16-years old female who was admitted to the
Neurology Emergency Unit Faculty of Medicine, Udayana
University, Sanglah General Hospital Bali, Indonesia due to
decreased consciousness, repetitive talking, headache,
involuntary movements in the mouth and feet, and seizures.
She was initially diagnosed with viral encephalitis and
symptomatic epilepsy. After four weeks of treatment, she
was referred to the Gynecology Department. Rectal
ultrasound revealed a cystic lesion with a solid component
measuring 3.6x2.64x3.18 cm from the left ovary. Laparotomy
cystectomy was performed, and the histopathological
examination revealed glial cells and mesoderm components
in the form of cartilage tissue. Serum and cerebrospinal fluid
were positive for anti-NMDA receptor antibodies. She was
treated with human intravenous immunoglobulin and
rituximab. Her condition was improved gradually. She
recovered fully after almost six weeks of hospitalisation.