Anti-N-methyl-d-aspartate Receptor Encephalitis Related Sinus Node Dysfunction and the Lock-Step Phenomenon.
Anti-N-methyl-d-aspartate Receptor Encephalitis Related Sinus Node Dysfunction and the Lock-Step Phenomenon.
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DOI：
10.12691/ajmcr-8-12-20
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
McFaralne SI
中科院分区：
文献类型：
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作者：
Patel KH;Chowdhury Y;Shetty M;Uppin V;Madaj P;Salifu MO;Youssef M;Henglein VL;McFaralne SI
在2007年描述，抗N-甲基-d-天冬氨酸受体脑炎（ANMDARE）是一种罕见的自身免疫性边缘系统脑炎，影响年轻人（主要是育龄妇女），是卵巢畸胎瘤的副肿瘤表现，约有一半的病例。ANMDARE的特征是精神变化、神经变化、自主神经不稳定和心律失常。在这份报告中，我们介绍了一名36岁的女性，她怀孕16周，因意识模糊被带到医院，随后癫痫发作，脑电图（EEG）显示出与ANMDARE一致的极端δ刷状模式。患者出现窦房结功能障碍，还发现卵巢畸胎瘤，这是ANMDARE的一种相当典型的表现，被认为是卵巢畸胎瘤的副肿瘤综合征。在这份报告中，我们强调了ANMDARE的心脏表现，与自主神经不稳定相关的病理生理学，以及这种罕见的，主要是破坏性疾病的管理策略。
Described in 2007, anti-N-methyl-d-aspartate receptor encephalitis (ANMDARE) is a rare autoimmune limbic encephalitis affecting young adults (predominantly women of reproductive age) and is a paraneoplastic manifestation of ovarian teratoma in about half of the cases. ANMDARE is characterized by psychiatric changes, neurological changes, autonomic instability and cardiac dysrhythmias. In this report, we present a 36-year-old woman who was 16 weeks pregnant and brought to the hospital with confusion and subsequently had a seizure with Electroencephalography (EEG) demonstrated an extreme delta brush pattern consistent with ANMDARE. Patient developed sinus nodal dysfunction and was also found to have ovarian teratoma, a rather typical presentation for ANMDARE, that is considered a paraneoplastic syndrome for ovarian teratoma. In this report, we highlight the cardiac manifestation of ANMDARE, the pathophysiology associated with autonomic instability, and management strategies of this rare, and largely devastating illness.