Anti-N-methyl-D-aspartate receptor encephalitis (Anti-NMDARE) is a synaptic autoimmune encephalitis syndrome mainly affecting young females. An underlying tumor, most commonly ovarian teratomas in young females, may indicate a paraneoplastic syndrome. Prognostic factors of the clinical course of disease and outcome play a central role in view of early administration of second-line immunotherapy and intensive-care therapy. We report a case of severe Anti-NMDARE associated with unfavorable predictors including an extreme delta brush (EDB) electroencephalographic-pattern and high anti-NMDAR-antibody titers in the cerebral spinal fluid (CSF), which necessitated the admission to an intensive care unit. In spite of the poor prognosis, the patient completely recovered; we attribute this to an early escalation to second-line immunotherapy with rituximab and multidisciplinary intensive-care therapy. The present case underlines the relevance of multidisciplinary management for individuals with Anti-NMDARE.

中文翻译：

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早期的多学科重症监护治疗可以改善以极端三角洲刷引起的严重抗NMDA受体脑炎的结果。

抗N-甲基-D-天冬氨酸受体脑炎（Anti-NMDARE）是一种突触性自身免疫性脑炎综合征，主要影响年轻女性。潜在的肿瘤，最常见于年轻女性的卵巢畸胎瘤，可能表明副肿瘤综合征。鉴于二线免疫治疗和重症监护治疗的早期给予，疾病的临床过程和结果的预后因素起着核心作用。我们报告了一例严重的抗NMDARE伴有不利的预测因素，包括极端脊髓电刷图（EDB）脑电图谱和脑脊液（CSF）中高抗NMDAR抗体滴度，这需要入院深切治疗。尽管预后很差，但患者已完全康复。我们将其归因于利妥昔单抗和多学科重症监护治疗的二线免疫治疗的早期升级。本案强调了多学科管理对具有Anti-NMDARE的个人的重要性。