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Anesthesia for patient with anti-N-methyl-D-aspartate receptor encephalitis: A case report with a brief review of the literature

RATIONALE: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an immune-mediated syndrome caused by the production of antibodies against NMDA receptors. As NMDA receptors are important targets of many anesthetic drugs, the perioperative management of patients with anti-NMDA receptor encephali...

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Autores principales: Wada, Nozomi, Tashima, Kayoko, Motoyasu, Akira, Nakazawa, Harumasa, Tokumine, Joho, Chinzei, Mieko, Yorozu, Tomoko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320089/
https://www.ncbi.nlm.nih.gov/pubmed/30558061
http://dx.doi.org/10.1097/MD.0000000000013651
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author Wada, Nozomi
Tashima, Kayoko
Motoyasu, Akira
Nakazawa, Harumasa
Tokumine, Joho
Chinzei, Mieko
Yorozu, Tomoko
author_facet Wada, Nozomi
Tashima, Kayoko
Motoyasu, Akira
Nakazawa, Harumasa
Tokumine, Joho
Chinzei, Mieko
Yorozu, Tomoko
author_sort Wada, Nozomi
collection PubMed
description RATIONALE: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an immune-mediated syndrome caused by the production of antibodies against NMDA receptors. As NMDA receptors are important targets of many anesthetic drugs, the perioperative management of patients with anti-NMDA receptor encephalitis is challenging for anesthesiologists. PATIENT CONCERNS: A 31-year-old woman presented with akinesia and aphasia, which worsened despite steroid therapy. DIAGNOSIS: Anti-NMDA receptor encephalitis associated with ovarian teratoma. INTERVENTIONS: Laparoscopic ovarian cystectomy was performed under total intravenous anesthesia (TIVA) with peripheral nerve block (PNB). OUTCOMES: The patient recovered without postoperative complications or any adverse events after surgery. LESSONS: Ideal anesthesia for a patient with anti-NMDA receptor encephalitis is still under discussion. We decided to perform TIVA with PNB because the effect of propofol on NMDA receptors is considered less than that of volatile anesthetics; moreover, PNB may reduce the amount of propofol and opioids required for anesthesia. To conclude, TIVA with PNB may be the most appropriate method for anesthesia in a patient with anti-NMDA receptor encephalitis undergoing ovarian cystectomy.
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spelling pubmed-63200892019-01-14 Anesthesia for patient with anti-N-methyl-D-aspartate receptor encephalitis: A case report with a brief review of the literature Wada, Nozomi Tashima, Kayoko Motoyasu, Akira Nakazawa, Harumasa Tokumine, Joho Chinzei, Mieko Yorozu, Tomoko Medicine (Baltimore) Research Article RATIONALE: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an immune-mediated syndrome caused by the production of antibodies against NMDA receptors. As NMDA receptors are important targets of many anesthetic drugs, the perioperative management of patients with anti-NMDA receptor encephalitis is challenging for anesthesiologists. PATIENT CONCERNS: A 31-year-old woman presented with akinesia and aphasia, which worsened despite steroid therapy. DIAGNOSIS: Anti-NMDA receptor encephalitis associated with ovarian teratoma. INTERVENTIONS: Laparoscopic ovarian cystectomy was performed under total intravenous anesthesia (TIVA) with peripheral nerve block (PNB). OUTCOMES: The patient recovered without postoperative complications or any adverse events after surgery. LESSONS: Ideal anesthesia for a patient with anti-NMDA receptor encephalitis is still under discussion. We decided to perform TIVA with PNB because the effect of propofol on NMDA receptors is considered less than that of volatile anesthetics; moreover, PNB may reduce the amount of propofol and opioids required for anesthesia. To conclude, TIVA with PNB may be the most appropriate method for anesthesia in a patient with anti-NMDA receptor encephalitis undergoing ovarian cystectomy. Wolters Kluwer Health 2018-12-14 /pmc/articles/PMC6320089/ /pubmed/30558061 http://dx.doi.org/10.1097/MD.0000000000013651 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Wada, Nozomi
Tashima, Kayoko
Motoyasu, Akira
Nakazawa, Harumasa
Tokumine, Joho
Chinzei, Mieko
Yorozu, Tomoko
Anesthesia for patient with anti-N-methyl-D-aspartate receptor encephalitis: A case report with a brief review of the literature
title Anesthesia for patient with anti-N-methyl-D-aspartate receptor encephalitis: A case report with a brief review of the literature
title_full Anesthesia for patient with anti-N-methyl-D-aspartate receptor encephalitis: A case report with a brief review of the literature
title_fullStr Anesthesia for patient with anti-N-methyl-D-aspartate receptor encephalitis: A case report with a brief review of the literature
title_full_unstemmed Anesthesia for patient with anti-N-methyl-D-aspartate receptor encephalitis: A case report with a brief review of the literature
title_short Anesthesia for patient with anti-N-methyl-D-aspartate receptor encephalitis: A case report with a brief review of the literature
title_sort anesthesia for patient with anti-n-methyl-d-aspartate receptor encephalitis: a case report with a brief review of the literature
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320089/
https://www.ncbi.nlm.nih.gov/pubmed/30558061
http://dx.doi.org/10.1097/MD.0000000000013651
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