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P.005 Ovarian resection in anti-NMDAr encephalitis

Published online by Cambridge University Press:  05 January 2022

Y Iyengar
Affiliation:
(Toronto)*
J Hébert
Affiliation:
(Toronto)*
SA Climans
Affiliation:
(Toronto)
RA Wennberg
Affiliation:
(Toronto)
DF Tang-Wai
Affiliation:
(Toronto)
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Abstract

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Background: Anti-N-methyl-D-aspartate receptor encephalitis (NMDArE) is commonly associated with ovarian teratomas, surgical resection of which can lead to significant neurologic improvement. However, the necessity of aggressive resection at the time of diagnosis is unknown; specifically, whether unilateral or bilateral oophorectomy, versus lesionectomy and partial oophorectomy (ovariotomy), is required. Methods: Eleven patients with NMDArE who underwent ovarian resection between January 1st 2012 and December 31st 2020 were retrospectively identified. Primary outcome was good one-year functional status, defined as modified Rankin Scale (mRS) score of 0-1. Results: Median age at encephalitis onset was 24 years (19–38); median delay from symptom onset to surgery was 39 days (16–129). Six patients (54.5%) had good mRS scores, unrelated to surgical resection type. Conclusions: Added clinical benefit of aggressive ovarian resection techniques at one-year follow-up was not identified in our data. Further longitudinal studies are needed to determine the indications for different surgical techniques in patients with NMDArE.

Ovarian resection approaches and associated functional outcomes in patients with NMDArE

Surgical approach, n (%)mRS 0–1 at 1-year, n (%)mRS 2-6 at 1-year, n (%)
Unilateral ovariotomy, 1 (9)1 (100)0 (0)
Unilateral oophorectomy, 5 (46)3 (60)2 (40)
Bilateral ovariotomy, 1 (9)1 (100)0 (0)
Bilateral oophorectomy, 4 (36)1 (25)3 (75)

Type
Poster Presentations
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation