Potential side effect of propofol and sevoflurane for anesthesia of anti-NMDA-R encephalitis
| Autor: | Jérôme Honnorat, Laurent Magy, F.X. Lapébie, Céline Kennel, Philippe Vignon, Bruno François, Nicolas Pichon, Fabrice Projetti |
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| Přispěvatelé: | Service d'Accompagnement et Soins Palliatifs [CHU Limoges], CHU Limoges, Service de Neurologie [CHU Limoges], Service d'Anatomie Pathologique [CHU Limoges], Centre de recherche en neurosciences de Lyon (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Réanimation Polyvalente [CHU Limoges], BMC, Ed., Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Methyl Ethers
Dyskinesia Drug-Induced medicine.medical_specialty Side effect [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] General anesthesia Case Report Sevoflurane Young Adult 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Anesthesiology medicine [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] Humans Anesthesia Propofol Anti-N-Methyl-D-Aspartate Receptor Encephalitis business.industry medicine.disease 3. Good health Anesthesiology and Pain Medicine Dyskinesia NMDA Anesthetics Inhalation Anesthetic NMDA receptor Encephalitis Drug Therapy Combination Female medicine.symptom business Anesthetics Intravenous 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | BMC Anesthesiology BMC Anesthesiology, BioMed Central, 2014, 14 (1), pp.5. ⟨10.1186/1471-2253-14-5⟩ BMC Anesthesiology, 2014, 14 (1), pp.5. ⟨10.1186/1471-2253-14-5⟩ |
| ISSN: | 1471-2253 |
| DOI: | 10.1186/1471-2253-14-5⟩ |
| Popis: | 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. High doses of methylprednisolone were administered. CT scan disclosed an ovarian teratoma and tumor resection was scheduled under anesthesia with propofol, sufentanil, atracurium and sevoflurane. Sedation after surgery was maintained with propofol. Rapidly after surgery, patient’s condition deteriorated with increase of dyskinesias, and two tonic-clonic generalized seizure events. Conclusion In patients with anti-NMDA-R encephalitis, anesthesia using benzodiazepines, opiates and curares, which fail to interfere with the NMDA pathway, should be preferred. |
| Databáze: | OpenAIRE |
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