Anesthetic management in a pediatric patient with Anti-NMDA receptor encephalitis

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Ampawan Tanyong


Background: Anti-NMDA receptor encephalitis
is an autoimmune disease with antibodies to N-methyl-
D-aspartate receptor, the group of the patient under
19 years old is around 20%. Pediatric predominant
symptoms are behavioral change, seizure, abnormal
movement and abnormal speech. The autonomic
nervous disturbances are hypotension, bradycardia,
hypoventilation, and apnea. Some anesthetic agents
affect NMDA receptor. Case report: A 7-year-old girl
with anti-NMDA receptor encephalitis underwent
gastrostomy under general anesthesia. The operation
was successful without any complications.
Conclusion: Anti NMDA receptor encephalitis
present with abnormal behavioral and autonomic
nervous disturbance. The action of some anesthetic
agent is similar to the disease. The anesthesiologists
should understand the disease and the patient’s vital
signs should be monitored closely. The anesthetics
that direct acting on NMDA receptor should be avoid.
Postoperative respiratory care is important.

Article Details

Case reports


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