Anti-N-Methyl-D-Aspartate Encephalitis asParaneoplastic Manifestation of Germ-Cells Tumours:A Cases Report and Literature Review

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is the most common form of autoimmune encephalitis, caused by theinteraction between an antibody and its target, located on glutamate receptor type N-methyl-D-aspartate (NMDA) of neuronalsurface. There is a wide spectrum of clinical features starting by a viral-like prodrome, followed by symptoms such as psychosis,aggressive behaviour, memory loss, seizures, movement disorders, and autonomic instability. Up to 50% of the affected young femalepatientshavegerm-cellstumoursasovarianteratoma,makingitessentialtoestablishanearlydiagnosisthroughdetectionofspecificantibodies in serum and cerebrospinal fluid (CSF). This retrospective observational study was performed in patients whom positiveanti-NMDA receptorantibodies havebeen tested,associated with clinical manifestations that suggest autoimmuneencephalitis anda germ-cell tumour confirmed by pathology. Six patients have tested positive for anti-NMDA receptor antibodies associated with agerm-cell tumour and clinical manifestations of autoimmune encephalitis. Management includes aggressive immunosuppressionand surgical removal