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Reminder of important clinical lesson
CASE REPORT
Anaesthetic management of a patient with a unique combination of anti-N-methyl-D-aspartate receptor encephalitis and stiff-person syndrome
  1. Mohammad Hadi Gharedaghi1,
  2. Arjang Khorasani2,
  3. Nebojsa Nick Knezevic2,
  4. Farzad Ebrahimi2
  1. 1Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA
  2. 2Department of Anesthesiology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
  1. Correspondence to Professor Farzad Ebrahimi, ebrahimi{at}uic.edu

Summary

Stiff-person syndrome (SPS) and anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis are rare paraneoplastic syndromes caused by antibodies that target the central nervous system. Here, we describe a 26-year-old woman who presented with psychosis, amnesia, rigidity and fever. After extensive diagnostic and laboratory workup, she was diagnosed with an ovarian teratoma which was causing the symptoms of anti-NMDAR encephalitis and SPS. The patient was successfully treated with laparoscopic removal of the ovarian tumour under general anaesthesia. She was placed on immunosuppressant medications preoperatively and postoperatively, and her symptoms gradually resolved. Although there are case reports regarding the anaesthetic management of SPS and anti-NMDAR encephalitis, our study is the first report of a patient afflicted with both conditions.

  • anaesthesia
  • gynecological cancer

https://doi.org/10.1136/bcr-2017-223261

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    Footnotes

    • Contributors AK and FE took care of the patient and wrote the manuscript. MHG and NNK contributed to the writing and reviewing of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.