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Immediate Postoperative Activation of Vagus Nerve Stimulation (VNS) for Super-refractory Status Epilepticus: A Case Report.
Cureus
December 2024
Clinical Research, National Institute of Neurology and Neurosurgery, Mexico City, MEX.
Anti-NMDA (N-methyl-D-aspartate) receptor encephalitis (ANRE) is a rare autoimmune condition targeting brain receptors, often linked to ovarian tumors in young women. In severe cases, it can lead to status epilepticus, but in sporadic cases, it may progress to super-refractory status epilepticus (SRSE), a dangerous state of continuous or repetitive seizures demanding urgent medical attention that continues or recurs more than 24 hours after the initiation of anesthetic therapy. We present a case report of anti-NMDA receptor limbic encephalitis-triggered SRSE terminated with vagus nerve stimulation (VNS) and titrated to high stimulation parameters in the immediate postoperative period.
View Article and Find Full Text PDFSuccessful treatment with efgartigimod as an add-on therapy for acute attack of anti-NMDA receptor encephalitis: a case report.
BMC Neurol
January 2025
Department of Neurology, Liuzhou People's Hospital affiliated to Guangxi Medical University, No.8 Rd.wenchang Liuzhou, Liuzhou, 545000, Guangxi Province, China.
Background: Anti-NMDA receptor encephalitis is an autoimmune, antibody-mediated inflammatory disease of the brain characterized by the presence of IgG antibodies targeting the excitatory N-methyl-D-aspartate receptor (NMDAR). Previous research has established that the neonatal Fc receptor (FcRn) regulates the transport and circulation of immunoglobulins (IgG). Efgartigimod, an FcRn antagonist, has been shown to enhance patient outcomes by promoting IgG clearance, and it has exhibited substantial clinical efficacy and tolerability in the treatment of myasthenia gravis.
View Article and Find Full Text PDFSeizures and status epilepticus in anti-NMDA receptor encephalitis.
J Neurol
January 2025
Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA.
Background: Seizures, including status epilepticus (SE), are common in anti-NMDA receptor encephalitis (NMDARE). We aimed to describe clinical and electrographic features of patients with seizures with NMDARE, determine factors associated with SE, and describe long-term seizure outcomes.
Methods: We retrospectively identified patients with seizures in the setting of NMDARE treated at inpatient Mayo Clinic sites during the acute phase of encephalitis between October 2008 and March 2023.
Anaesthetic management of laparotomy in a patient with anti-NMDA receptor antibody-mediated encephalitis.
BMJ Case Rep
January 2025
Anaesthesiology, St John's National Academy of Health Sciences, Bangalore, Karnataka, India.
Management of cases of anti-N-methyl-D-aspartate (NMDA) antibody-mediated encephalitis is very challenging to anaesthesiologists as this receptor is the target of many anaesthetics. We report a woman diagnosed with anti-NMDA antibody-mediated encephalitis posted for laparotomy. She presented with generalised tonic-clonic seizures.
View Article and Find Full Text PDFPrecision Assessment of Anti-NMDA Receptor Encephalitis: A Case Report on Integrating Clinical Course, Immunophenotyping, and Comprehensive Symptomatology in a Pediatric Patient With Adjunctive Hydrogen Therapy.
In Vivo
December 2024
Rheumatology/Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.;
Background/aim: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, though rare, is the most common form of autoimmune encephalitis, predominantly affecting young individuals, particularly females. Standard treatments include corticosteroids, intravenous immunoglobulins (IVIG), and plasmapheresis, with rituximab recommended for those unresponsive to first-line therapies. However, reliable biomarkers for clinical assessment remain elusive.
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