A case of anti-N-methyl-D-aspartate receptor encephalitis with associated ovarian teratoma in a 23-year-old female
Bibliographic record
Abstract
Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is an immune-mediated disease manifesting with a complex neuropsychiatric syndrome and anti-NMDA receptor antibodies within the cerebrospinal fluid. If not treated, it can progress to hypoventilation, coma, or death. It is often misdiagnosed as drug abuse, neuroleptic malignant syndrome, primary psychiatric disorder, or viral encephalitis. Despite its severity, the condition is highly responsive to treatment through decreasing antibody titers, and much of the potential morbidity can be avoided if it is recognized quickly. This case report describes a 23-year-old female from South Korea with no significant past medical history who presented to the emergency department with memory loss and migraine for 1 week. High levels of anti-NMDA receptors were identified. The diagnosis of anti-NMDA receptor encephalitis was further supported by computed tomography and magnetic resonance imaging findings of encephalitis and an ovarian teratoma, a common associated finding. Despite aggressive treatment with intravenous immunoglobulin, glucocorticoids and monoclonal antibodies, the patient failed to demonstrate a normal level of consciousness for the majority of the admission period and contracted numerous nosocomial infections. This case of a young, previously-well female outlines the need for early detection and treatment of this condition, considering the severe symptoms and deleterious outcomes. Its diagnosis relies on physicians having a high index of suspicion in young females presenting with acute psychiatric and neurological symptoms, as well as a focus on early appropriate radiological imaging. Further research is necessary on anti-NMDA-related conditions so that a timely, multidisciplinary approach to screening, diagnosis and treatment can be initiated.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".