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Case report: Anti-N-methyl-D-aspartate receptor encephalitis and its anesthetic implications
Peter Gabriel Pryzbylkowski1, William Jonathan Dunkman, Renyu Liu
1Department of Anesthesiology and Critical Care, University of Pennsylvania Health System, Hospital of the University of Pennsylvania, Dulles 772, 3400 Spruce St., Philadelphia, PA 19104, USA.
Abstract:
We describe the anesthetic management and implications of 2 patients with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis. Anti-NMDA receptor encephalitis is a neurological disorder caused by production of antibodies to the NMDA receptor. The NMDA receptor is the target of many drugs used in anesthesia. It is important to understand the pharmacologic interactions these anesthetics have with a disabled NMDA receptor while preparing an anesthetic plan for patients with anti-NMDA receptor encephalitis. Symptoms of the disease such as psychosis, paroxysmal sympathetic hyperactivity, and central hypoventilation pose risks to the induction and maintenance of anesthesia in these patients.
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