Category: Autoimmune Movement Disorders
Objective: To describe three severe cases of anti-NMDAR encephalitis in young females after the COVID-19 cross-vaccination.
Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most recognized autoimmune encephalitis in the neurology practice. Clinical presentations are a combination of acute to subacute neuropsychiatric symptoms, sleep disturbances, cognitive decline, seizure, and movement disorders. This condition is associated with an ovarian teratoma. Treatments are surgical removal and intravenous immunoglobulin. Many previous reports revealed good outcomes from the treatment.
Method: Case series
Results: All three cases were positive NMDAR antibodies in CSF. Each developed illnesses within two weeks after the COVID-19 cross-vaccination: viral vector followed by mRNA vaccine. The first and the third cases had an ovarian teratoma. The first case is a 22-year-old female who developed acute confusion and generalized chorea within one week. The clinical course was a rapid progression. She suffered from refractory status epilepticus and generalized chorea. Although two courses of IVIg and one course of IVMP were prescribed, chorea subsided, but an intravenous thiopentone was continuously given. She passed away due to sepsis. The second case was a 16-year-old girl who developed left hemiparesis with jerky movement of the left arm and repetitive eye blinking with orobuccal chorea for one week. The EEG revealed status epilepticus. Her CT brain showed a hypodensity lesion involving the right parietal-temporal subcortex. After treatment, the status epilepticus subsided. However, her consciousness was drowsiness, and the left hemiplegia persisted. The relapse occurred within six months. The third case was a 20-year-old female who experienced acute confusion, auditory hallucinations, and self-injury. The EEG revealed non-convulsive status epilepticus. Refractory epilepsy and chorea persisted, although IVIg+IVMP+ Cyclophosphamide was prescribed.
Conclusion: Three cases of anti-NMDAR encephalitis followed by COVID-19 cross-vaccination were fatal cases and poor prognosis.
To cite this abstract in AMA style:
K. Methawasin, P. Tungkiatsilp, C. Suthamdireklap, M. Jaisa-Aad. Severe Anti-NMDAR Encephalitis After the Covid 19 Cross-vaccination in three young women [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/severe-anti-nmdar-encephalitis-after-the-covid-19-cross-vaccination-in-three-young-women/. Accessed October 5, 2026.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/severe-anti-nmdar-encephalitis-after-the-covid-19-cross-vaccination-in-three-young-women/