Anti-NMDA receptor encephalitis is part of the paraneoplastic limbic encephalitis group and presents with amnesia and behavioral disturbance greater than psychosis, seizures, involuntary movements, and autonomic instability; it most often affects young women and is commonly associated with ovarian teratoma.

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Anti-NMDA receptor encephalitis is an autoimmune encephalitis driven by antibodies against NMDA receptors, and it is classically seen in young women with an associated ovarian teratoma. The hallmark is prominent neuropsychiatric symptoms that can resemble a primary psychotic disorder, often starting with behavioral changes and amnesia, followed by seizures, movement abnormalities (such as orofacial dyskinesias), and autonomic instability. This pattern fits the vignette best: amnesia and behavioral disturbance that are prominent, in a young woman, with a strong link to an ovarian teratoma. The underlying mechanism involves antibodies causing internalization and hypofunction of NMDA receptors in limbic and cortical regions, leading to the cognitive and psychiatric features, seizures, and autonomic symptoms. Treatment centers on immunotherapy and removing the tumor, which often leads to substantial improvement. Other paraneoplastic limbic encephalitis presentations can involve different antibodies and tumor associations and may not feature the same prominent psychiatric onset or the ovarian teratoma link; cerebellar degeneration presents mainly with ataxia, and Sheehan syndrome centers on postpartum pituitary failure, not this neuropsychiatric and tumor-linked pattern.