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Case No. 427
2016-11-01~2016-11-30
출제자 : 유인선
Hit : 442
| Period | 2016-11-01~2016-11-30 |
|---|---|
| Diagnosis | Anti-NMDA receptor encephalitis |
| Clinical information | F/51 C.C> 10일전 시작된 anxiety, confusion after flu-like symptoms. PMHx> Rt ovarian mass excision: immature teratoma (high grade) |
| Discussion | • NMDA receptor - found throughout the brain, far more dense concentration in the hippocampus - main role : involvement in synaptic transmission and neuronal plasticity - receptor plays a role in the pathogenesis of schizophrenia, dementia, epilepsy • Anti NMDA receptor encephalitis - identification of disease-causing antibodies made in 2007 - one of autoimmune limbic encephalopathy - mostly affects young women and children - about 60% cases associated with ovarian teratomas : * identification and removal of tumor are crucial! • Symptom - initial phase include a flu-like illness - followed by psychiatric disorders (psychosis, hallucinations, anxiety, agitation) - Overall clinical course is variable, ranging from full recovery to death (4%) • Imaging findings - up to 50% patients show abnormal MR finding but nonspecific - Abnormal FLAIR or T2 high signal lesion in medial temporal lobes/ hippocampus, cerebral/cerebellar cortex, BG and brainstem. No enhancement, No hemorrhage |
| Correct answer |
Correct Answer
Semi-Correct Answer |