Clinical – patient studies

Journal of Neuro-Oncology

, Volume 81, Issue 1, pp 71-74

EFA6A-like antibodies in paraneoplastic encephalitis associated with immature ovarian teratoma: a case report

  • Reiji KoideAffiliated withDepartment of Neurology, Tokyo Metropolitan Neurological Hospital Email author 
  • , Toshio ShimizuAffiliated withDepartment of Neurology, Tokyo Metropolitan Neurological Hospital
  • , Kazunori KoikeAffiliated withDepartment of Obstetrics and Gynecology, Tokyo Metropolitan Fuchu Hospital
  • , Josep DalmauAffiliated withDivision of Neuro-oncology, Department of Neurology, University of Pennsylvania

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access


We describe a 19-year-old patient with paraneoplastic encephalitis associated with immature ovarian teratoma (OT), who presented with psychiatric symptoms, prolonged disturbance of consciousness, refractory status epilepticus, central hypoventilation, and various abnormal involuntary movements. Immunological characterization of the patient’s serum and cerebrospinal fluid (CSF) demonstrated the presence of an autoantibody that colocalized with EFA6A, a brain-specific protein involved in the regulation of dendritic development of hippocampal neurons. Despite the severity of the symptoms, the patient showed significant neurological improvement following removal of the tumor and chemotherapy. This case suggests that physicians should rule out an OT in young women with encephalitis who present with the subacute-onset of psychiatric symptoms. Antibodies that colocalize with EFA6A are a valuable marker for early diagnosis of a potentially reversible paraneoplastic encephalitis associated with OT.


EFA6A Ovarian teratoma Paraneoplastic encephalitis Status epilepticus Involuntary movement disorder