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Central neurogenic hyperventilation in anti-NMDA receptor encephalitis
Atay Vural1, Ethem Murat Arsava, Nese Dericioglu
1Department of Neurology, Hacettepe University Hospitals, Turkey.
Internal Medicine (Tokyo, Japan)
|October 6, 2012
Summary
Central neurogenic hyperventilation (CNH), a rare brainstem tumor complication, was observed in anti-N-methyl D-aspartate (NMDA) receptor encephalitis. This finding suggests NMDA receptors may influence CNH development.
Area of Science:
- Neurology
- Neuroimmunology
Background:
- Central neurogenic hyperventilation (CNH) is a rare respiratory disorder typically linked to brainstem tumors.
- Anti-N-methyl D-aspartate (NMDA) receptor encephalitis is an autoimmune condition often presenting with neurological and psychiatric symptoms, including respiratory dysfunction.
Observation:
- This case report describes a 24-year-old woman diagnosed with anti-NMDA receptor encephalitis secondary to an ovarian teratoma.
- The patient experienced recurrent episodes of CNH, a symptom not previously documented in this encephalitis.
- CNH episodes were successfully managed with midazolam and propofol infusions.
Findings:
- The occurrence of CNH in the context of anti-NMDA receptor encephalitis is reported for the first time.
- Successful treatment of CNH with sedatives (midazolam, propofol) and disease-specific therapies (oopherectomy, plasmapheresis, IVIg) highlights the patient's recovery.
Implications:
- The findings suggest a potential role for NMDA receptors in the pathophysiology of central neurogenic hyperventilation.
- This case expands the spectrum of respiratory dysfunctions associated with anti-NMDA receptor encephalitis.
- Further research may elucidate the precise mechanisms linking NMDA receptors to CNH.
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