NMDA receptor antibody in teratoma-related opsoclonus-myoclonus syndrome.

Abstract

Opsoclonus-myoclonus syndrome (OMS) is a brainstem/cerebellar syndrome producing disabling multi-directional saccadic oscillations with oscillopsia, with or without somatic myoclonus and cerebellar ataxia (Wong et al., 2001; Armangué et al., 2016). OMS is presumed to have an autoimmune basis and patients with it are tested for antineuronal antibodies and have imaging to locate any tumors. Here we report a unusual case of a young woman who had NMDAR antibody (NMDAR-ab) positive, teratoma-related, isolated OMS without encephalopathy. Removal of her ovarian teratoma, and immunotherapy with steroids, intravenous immunoglobulin (IVIg), plasma exchange (PLEX), and ultimately with B-cell depletion with rituximab resulted in total recovery after 3 months. Patients with teratoma-related OMS very rarely have NMDAR-ab which suggests that it is not the NMDAR-ab per se that causes the OMS.

• Authors: Nicolás X Urriola, Jacob Helou, Joel Maamary, Jacob Pogson, Frederick Lee, Kaitlyn Parratt, David Gillis, Michael J Fulham, G Michael Halmágyi
• Journal: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (J Clin Neurosci) Vol. 58 Pg. 203-204 (Dec 2018) ISSN: 1532-2653 [Electronic] Scotland
• PMID: 30340968 (Publication Type: Case Reports, Journal Article)
• Copyright: Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Autoantibodies
• Receptors, N-Methyl-D-Aspartate

Topics

• Adult
• Autoantibodies (cerebrospinal fluid, immunology)
• Female
• Humans
• Opsoclonus-Myoclonus Syndrome (immunology)
• Ovarian Neoplasms (complications, immunology)
• Receptors, N-Methyl-D-Aspartate (immunology)
• Teratoma (complications, immunology)