International Journal of Research in Medical Sciences | September 2022 | Vol 10 | Issue 9 Page 2052 International Journal of Research in Medical Sciences Kumar A et al. Int J Res Med Sci. 2022 Sep;10(9):2052-2055 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Case Report A rare case of paraneoplastic neurological syndrome with ovarian teratoma Anita Kumar, Anjali Dabral, Megha Panwar*, Bindu Bajaj, Sukanya Sanapala, Deepti Sharma INTRODUCTION Paraneoplastic neurological syndrome (PNS) is defined as the pathological involvement of the nervous system in the course of malignancy. In case of ovarian malignancy, the patient may present with neuropsychiatric symptoms prior to the symptoms of ovarian neoplasm. Autoimmune mechanism is suggested as the ovarian tissue and the nervous tissue share some common antigens (eg- CDR2, NMDAR). Antibody mediated immune response is responsible for the neurological symptoms. The detection of onconeural antibodies (eg- Anti-yo) strongly indicates the presence of ovarian tumor in patients with neurological deficit. Due to wide array of symptoms multidisciplinary approach is required for PNS including surgery and immunomodulation. 1 CASE REPORT We are reporting a case of a 23-year-old married nulliparous female who came to the gynaecology OPD with a history of a mass per abdomen for past four months and with gradual onset of gait disturbance, dysphonia, memory loss and cognitive impairment for the past five month. She was not able to perform her daily activities without someone’s help. She had no prior history of psychiatric or neurological condition. There was no family history of psychological and psychiatric complaints. No history of alcohol, drugs consumption or smoking. History was given by her mother. She had taken psychiatry and neurology consultation and was prescribed medications but her symptoms were not relieved. She had started complaining of abdominal pain also for which she was brought to gynaecology OPD. On neurological Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India Received: 01 July 2022 Accepted: 30 July 2022 *Correspondence: Dr. Megha Panwar, E-mail: meghapanwar11@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Paraneoplastic neurological syndrome (PNS) is a neuropathological disorder of central nervous system, in this the patient presents with a tumor anywhere in the body with diverse neuropsychiatric symptoms. The clinical manifestation of the tumor may be preceded by PNS. We are reporting a case of a 23-year-old married nulliparous female who came to the gynaecology outpatient department (OPD) with the history of mass per abdomen for the past four months and also undergoing treatment for acute psychosis, memory loss and cognitive impairment for the past five months. Her symptoms were not relieved on treatment. After clinical, laboratory and radiological evaluation possibility of paraneoplastic neurological syndrome associated with ovarian teratoma was made. Patient was taken up for staging laparotomy with U/L salpingoophrectomy. After surgical treatment her psychiatric symptoms rapidly improved and her psychiatric medications doses was reduced. PNS should be suspected in female patients presenting with an acute history of neuropsychiatric symptoms. Tumor resection should be performed at the earliest to improve patient outcomes. Keywords: Paraneoplastic neurological syndromes, Immature teratoma, Gliomatosis peritonei, Case report DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20222289