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Nmda receptor encephalitis Anesthesia

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https://www.readbyqxmd.com/read/27610299/successful-management-of-dexmedetomidine-for-postoperative-intensive-care-sedation-in-a-patient-with-anti-nmda-receptor-encephalitis-a-case-report-and-animal-experiment
#1
Daiki Yamanaka, Takashi Kawano, Hiroki Tateiwa, Hideki Iwata, Fabricio M Locatelli, Masataka Yokoyama
BACKGROUND: Anti-N-methyl-d-aspartate receptor (NMDA-R) encephalitis is a recently identified but increasingly recognized autoimmune paraneoplastic disease. Because these patients present complex neuropsychiatric symptoms due to NMDA-R dysfunction, the optimal methods of sedation/anesthesia remain controversial. Here, we present animal experiment data, along with a related case report, implying the safe and effective use of dexmedetomidine in patients with anti-NMDA-R encephalitis. FINDINGS: (1) Animal experiment: in order to investigate whether dexmedetomidine may interfere with NMDA-R activity, an NMDA antagonist (MK-801) model in rats was used to simulate anti-NMDA-R encephalitis...
2016: SpringerPlus
https://www.readbyqxmd.com/read/26922283/anti-nmda-r-encephalitis-should-we-consider-extreme-delta-brush-as-electrical-status-epilepticus
#2
Eve Chanson, Élodie Bicilli, Michel Lauxerois, Sophie Kauffmann, Russell Chabanne, François Ducray, Jérome Honnorat, Pierre Clavelou, Sarah Rosenberg
Seizures are common clinical manifestations in anti-N-methyl-d-aspartate receptor (anti-NMDA-R) encephalitis, among other neurological and psychiatric symptoms. During the course of the disease, some specific EEG patterns have been described: generalized rhythmic delta activity (GRDA) and extreme delta brush (EDB). In comatose patients, the association of these EEG abnormalities with subtle motor manifestations can suggest ongoing non-convulsive status epilepticus (NCSE). We report the case of a 28-year-old woman admitted for a clinical presentation typical of anti-NMDA-R encephalitis, which was confirmed by CSF analysis...
February 2016: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/25842641/anesthetic-management-and-implications-of-pediatric-patients-with-a-diagnosis-of-anti-n-methyl-d-aspartate-receptor-encephalitis-two-case-reports
#3
Robert W Simon
This article discusses the anesthetic management and implications of 2 pediatric patients with a diagnosis of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis. Anti-NMDA receptor encephalitis has been described as an immune-meditated syndrome that triggers the production of antibodies to the NMDA receptor: a site of action for many commonly used anesthetic agents. Symptoms of this disease can be autonomic, neurologic, and psychological in nature. This disease process can pose a challenge to the anesthesia provider during all stages of the anesthetic...
December 2014: AANA Journal
https://www.readbyqxmd.com/read/25611647/total-intravenous-anesthesia-using-n-methyl-d-aspartate-nmda-receptor-sparing-drugs-in-a-patient-with-anti-nmda-receptor-encephalitis
#4
Daniel K Broderick, Douglas E Raines, Karen C Nanji
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a recently identified syndrome characterized by psychosis and dysautonomia. Treatment includes resection of the underlying tumor. While the pathologic mechanism involves disruption of NMDA function by anti-NMDA receptor autoantibodies, there are few descriptions of the perioperative management or anesthetic approach for such patients. We report a classic presentation of anti-NMDA receptor encephalitis and describe the use of total IV anesthesia with NMDA receptor-sparing drugs...
April 1, 2014: A & A Case Reports
https://www.readbyqxmd.com/read/24890178/anesthesia-management-for-a-patient-with-anti-nmda-receptor-encephalitis-undergoing-ovarian-tumor-resection
#5
Yu Lang, Tianlong Wang, Fei Lan, Wei Xiao
No abstract text is available yet for this article.
2014: Chinese Medical Journal
https://www.readbyqxmd.com/read/24433363/potential-side-effect-of-propofol-and-sevoflurane-for-anesthesia-of-anti-nmda-r-encephalitis
#6
François-Xavier Lapébie, Céline Kennel, Laurent Magy, Fabrice Projetti, Jérôme Honnorat, Nicolas Pichon, Philippe Vignon, Bruno François
BACKGROUND: Many anesthetic drugs interact with the NMDA receptor and may therefore alter the clinical presentation of anti-NMDA-R encephalitis. CASE PRESENTATION: A 24-year-old woman was admitted to hospital for decreased consciousness and hyperthermia. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, and elevated protein. Cultures were negative. Patient state worsened with agitation, facial dyskinesia, ocular deviation, and limb dystonia. Diagnosis of anti-NMDA-R encephalitis was evidenced by specific antibodies...
2014: BMC Anesthesiology
https://www.readbyqxmd.com/read/21918158/case-report-anti-n-methyl-d-aspartate-receptor-encephalitis-and-its-anesthetic-implications
#7
Peter Gabriel Pryzbylkowski, William Jonathan Dunkman, Renyu Liu, Linda Chen
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...
November 2011: Anesthesia and Analgesia
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