• Joravar Dhaliwal, Ranjit Ganguly, Jesse Mindel, and Vibhor Krishna.
• Department of Neurosurgery, Ohio State University Wexner Medical Center, Columbus, Ohio, USA. Electronic address: joravar.dhaliwal@osumc.edu.
• World Neurosurg. 2021 Feb 1; 146: 364-366.e2.

BackgroundAnti-NMDA receptor encephalitis (ANRE) is a rare autoimmune neurologic disorder characterized by encephalitis and a constellational of symptoms, including seizures, psychiatric disturbances, autonomic instability, and respiratory insufficiency. It is caused by the anti-NMDA receptor antibody. The most common etiologies for ANRE include malignancy and infection. Ovarian teratoma is the most commonly associated malignancy.Case DescriptionWe describe the first reported case to our knowledge of ovarian teratoma causing ANRE resulting in nonconvulsive status epilepticus (NCSE), which was terminated with vagus nerve stimulation (VNS).ConclusionsThis case report provides a temporal correlation suggesting that VNS significantly altered the natural history of this patient's NCSE-ANRE. As more data are collected, and the VNS treatment modality more liberally used to treat NCSE, especially in the situation of ANRE, stronger layers of evidence will emerge to fill the gaps of understanding beyond this case report.Copyright © 2020 Elsevier Inc. All rights reserved.

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