Profound Autonomic Instability Complicated by Multiple Episodes of Cardiac Asystole and Refractory Bradycardia in a Patient with Anti-NMDA Encephalitis
Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE) is autoimmune encephalitis primarily affecting young adults and children. First described about a decade ago, it frequently manifests as a syndrome that includes progressive behavioral changes, psychosis, central hypoventilation, seizures...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2016/7967526 |
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| author | Stephanie R. Mehr Roy C. Neeley Melissa Wiley Avinash B. Kumar |
| author_facet | Stephanie R. Mehr Roy C. Neeley Melissa Wiley Avinash B. Kumar |
| author_sort | Stephanie R. Mehr |
| collection | DOAJ |
| description | Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE) is autoimmune encephalitis primarily affecting young adults and children. First described about a decade ago, it frequently manifests as a syndrome that includes progressive behavioral changes, psychosis, central hypoventilation, seizures, and autonomic instability. Although cardiac arrhythmias often accompany anti-NMDARE, the need for long-term electrophysiological support is rare. We describe the case of NMDARE whose ICU course was complicated by progressively worsening episodes of tachyarrhythmia-bradyarrhythmia and episodes of asystole from which she was successfully resuscitated. Her life-threatening episodes of autonomic instability were successfully controlled only after the placement of a permanent pacemaker during her ICU stay. She made a clinical recovery and was discharged to a skilled nursing facility after a protracted hospital course. |
| format | Article |
| id | doaj-art-7031be58a7b74bd286b9475bb84fbd87 |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-7031be58a7b74bd286b9475bb84fbd872025-02-03T06:01:36ZengWileyCase Reports in Neurological Medicine2090-66682090-66762016-01-01201610.1155/2016/79675267967526Profound Autonomic Instability Complicated by Multiple Episodes of Cardiac Asystole and Refractory Bradycardia in a Patient with Anti-NMDA EncephalitisStephanie R. Mehr0Roy C. Neeley1Melissa Wiley2Avinash B. Kumar3Department of Anesthesiology, Vanderbilt University, Nashville, TN 37212, USADepartment of Anesthesiology, Division of Critical Care, Vanderbilt University, Nashville, TN 37212, USADepartment of Anesthesiology, Vanderbilt University, Nashville, TN 37212, USADepartment of Anesthesiology, Division of Critical Care, Vanderbilt University, Nashville, TN 37212, USAAnti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE) is autoimmune encephalitis primarily affecting young adults and children. First described about a decade ago, it frequently manifests as a syndrome that includes progressive behavioral changes, psychosis, central hypoventilation, seizures, and autonomic instability. Although cardiac arrhythmias often accompany anti-NMDARE, the need for long-term electrophysiological support is rare. We describe the case of NMDARE whose ICU course was complicated by progressively worsening episodes of tachyarrhythmia-bradyarrhythmia and episodes of asystole from which she was successfully resuscitated. Her life-threatening episodes of autonomic instability were successfully controlled only after the placement of a permanent pacemaker during her ICU stay. She made a clinical recovery and was discharged to a skilled nursing facility after a protracted hospital course.http://dx.doi.org/10.1155/2016/7967526 |
| spellingShingle | Stephanie R. Mehr Roy C. Neeley Melissa Wiley Avinash B. Kumar Profound Autonomic Instability Complicated by Multiple Episodes of Cardiac Asystole and Refractory Bradycardia in a Patient with Anti-NMDA Encephalitis Case Reports in Neurological Medicine |
| title | Profound Autonomic Instability Complicated by Multiple Episodes of Cardiac Asystole and Refractory Bradycardia in a Patient with Anti-NMDA Encephalitis |
| title_full | Profound Autonomic Instability Complicated by Multiple Episodes of Cardiac Asystole and Refractory Bradycardia in a Patient with Anti-NMDA Encephalitis |
| title_fullStr | Profound Autonomic Instability Complicated by Multiple Episodes of Cardiac Asystole and Refractory Bradycardia in a Patient with Anti-NMDA Encephalitis |
| title_full_unstemmed | Profound Autonomic Instability Complicated by Multiple Episodes of Cardiac Asystole and Refractory Bradycardia in a Patient with Anti-NMDA Encephalitis |
| title_short | Profound Autonomic Instability Complicated by Multiple Episodes of Cardiac Asystole and Refractory Bradycardia in a Patient with Anti-NMDA Encephalitis |
| title_sort | profound autonomic instability complicated by multiple episodes of cardiac asystole and refractory bradycardia in a patient with anti nmda encephalitis |
| url | http://dx.doi.org/10.1155/2016/7967526 |
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