Anesthesia in anti-N-methyl-D-aspartate receptor encephalitis - is general anesthesia a requisite? A case report

Sook Hui Chaw; Li Lian Foo; Lucy Chan; Kang Kwong Wong; Suhailah Abdullah; Boon Kiong Lim

doi:10.1016/j.bjane.2014.11.007

Clinical Informations

Anesthesia in anti-N-methyl-D-aspartate receptor encephalitis - is general anesthesia a requisite? A case report

Anestesia em encefalite antirreceptor de N-metil-D-aspartato - a anestesia geral é um requisito? Relato de caso

Sook Hui Chaw; Li Lian Foo; Lucy Chan; Kang Kwong Wong; Suhailah Abdullah; Boon Kiong Lim

http://dx.doi.org/10.1016/j.bjane.2014.11.007 Braz J Anesthesiol, vol.67, n6, p.647-650, 2017

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Abstract

Abstract Anti-N-methyl-D-aspartate receptor encephalitis is a recently described neurological disorder and an increasingly recognized cause of psychosis, movement disorders and autonomic dysfunction. We report 20-year-old Chinese female who presented with generalized tonic-clonic seizures, recent memory loss, visual hallucinations and abnormal behavior. Anti-N-methyl-D-aspartate receptor encephalitis was diagnosed and a computed tomography scan of abdomen reviewed a left adnexal tumor. We describe the first such case report of a patient with anti-N-methyl-D-aspartate receptor encephalitis who was given a bilateral transversus abdominis plane block as the sole anesthetic for removal of ovarian tumor. We also discuss the anesthetic issues associated with anti-N-methyl-D-aspartate receptor encephalitis. As discovery of tumor and its removal is the focus of initial treatment in this group of patients, anesthetists will encounter more such cases in the near future.

Keywords

Anti-N-methyl-d-aspartate receptor encephalitis, Transversus abdominis plane block, Anti-NMDA receptor encephalitis and anesthesia

Resumo

Resumo A encefalite antirreceptor de N-metil-D-aspartato (NMDA) é um distúrbio neurológico recentemente descrito e uma causa cada vez mais reconhecida de psicose, distúrbios do movimento e disfunção autonômica. Relatamos o caso de uma paciente de origem chinesa, de 20 anos, que se apresentou com crises tônico-clônicas generalizadas, perda de memória recente, alucinações visuais e comportamento anormal. Encefalite antirreceptor de NMDA foi diagnosticada e uma tomografia computadorizada de abdome revelou um tumor anexial à esquerda. Descrevemos o primeiro relato de caso de paciente com encefalite antirreceptor de NMDA submetida ao bloqueio de plano transverso abdominal (PTA) bilateral como única anestesia para remoção de tumor ovariano. Também discutimos as questões anestésicas associadas à encefalite antirreceptor de NMDA. Como a descoberta e a remoção do tumor são o foco do tratamento inicial nesse grupo de pacientes, os anestesiologistas encontrarão mais desses casos no futuro próximo.

Palavras-chave

Encefalite antirreceptor de N-metil-d-aspartato, Bloqueio do plano transverso abdominal, Encefalite antirreceptor de NMDA e anestesia

References

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Anesthesia in anti-N-methyl-D-aspartate receptor encephalitis - is general anesthesia a requisite? A case report

Anestesia em encefalite antirreceptor de N-metil-D-aspartato - a anestesia geral é um requisito? Relato de caso

Sook Hui Chaw; Li Lian Foo; Lucy Chan; Kang Kwong Wong; Suhailah Abdullah; Boon Kiong Lim

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