title: Case report: Anti-N-methyl-D-aspartate receptor encephalitis and its anesthetic implications.
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.
authors.affiliation: Department 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.
authors.forename: Peter Gabriel
authors.initials: PG
authors.lastname: Pryzbylkowski
authors.forename: William Jonathan
authors.initials: WJ
authors.lastname: Dunkman
authors.forename: Renyu
authors.initials: R
authors.lastname: Liu
authors.forename: Linda
authors.initials: L
authors.lastname: Chen
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D000758:Anesthesia; D000768:Anesthesia, General; D001323:Autoantibodies / Q000276:immunology; D004660:Encephalitis / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005743:Gastrectomy; D006801:Humans; D004091:Hydromorphone / Q000627:therapeutic use; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D010535:Laparoscopy; D008140:Lorazepam / Q000627:therapeutic use; D008297:Male; D010048:Ovarian Cysts / Q000601:surgery; D010052:Ovariectomy; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors* / Q000276:immunology*; D014139:Tracheostomy; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D001323:Autoantibodies; D006993:Hypnotics and Sedatives; D016194:Receptors, N-Methyl-D-Aspartate; D008140:Lorazepam; D004091:Hydromorphone