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Anti-NMDAR – Symptom Progression Stages — SCE Neurology MCQ

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HardCNS InfectionsAnti-NMDAR – Symptom Progression StagesSCE Neurology

A 27-year-old with confirmed anti-NMDA-receptor encephalitis has an ovarian teratoma, frequent dyskinesias, alternating bradycardia and tachycardia, and episodes of hypoventilation. Which management plan should be prioritised?

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Correct answer: C — Critical-care support, first-line immunotherapy and teratoma removal during the same admission

Dysautonomia and hypoventilation in anti-NMDA-receptor encephalitis can become life-threatening and require high-dependency or intensive-care monitoring. Because the tumour can drive the immune process, treatment components should proceed in parallel: first-line immunotherapy, organ support and removal of the associated ovarian teratoma. Antiseizure or psychiatric medicines may control individual manifestations but do not treat the underlying immune process. Serial antibody titres do not determine when tumour treatment should occur.

Reference: Autoimmune encephalitis: clinical spectrum and management: https://pn.bmj.com/content/21/5/412