Anesthesia Management for Patients with Anti-N- Methyl-D-Aspartate Receptor Encephalitis

As one of the paraneoplastic limbic encephalitis, anti-NMDA receptor encephalitis, autoimmune mediated, is disclosed by Josep Dalmau of department of neurology of university of Pennsylvania in 2007, though it had been reported since 1981. Young women (aged 14-44, median 27) are susceptible to anti-NMDA receptor encephalitis usually combined with mature cystic teratoma (approximately 54%), in addition, children and men are also described having this disorder [1]. Testicular germ cell tumor, small cell lung cancer or thymomas sometimes can lead to paraneoplastic limbic encephalitis [2]. About 86% of patients have prodromal syndrome 2 weeks prior like viral upper respiratory tract infection, and then the patients go through a multistage disorder progressing from psychiatric symptoms, memory deficits, seizures, and language disintegration into a state of unresponsiveness, catatonia and autonomic disequilibrium. Notably, 75% of patients with the anti-NMDA receptor encephalitis substantially recovered in a reverse order of the illness development [2].