Inayat Faisal, Hung Pinto Wikien A, Ahmad Soban, Hussain Amna, Ullah Waqas
Internal Medicine, Allama Iqbal Medical College, Lahore, PAK.
Internal Medicine, Einstein Medical Center, Philadelphia, USA.
Cureus. 2019 Jun 5;11(6):e4837. doi: 10.7759/cureus.4837.
Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is a rare clinical entity that typically presents with psychiatric disturbances and neurological deficits. It is commonly associated with ovarian teratomas. Although these patients demonstrate a predilection to develop cardiac arrhythmias, such complications are frequently self-limited. We chronicle here a unique case of a young woman with adnexal teratoma who experienced a tonic-clonic seizure and cardiac arrest. Electrocardiogram showed polymorphic ventricular tachycardia, consistent with torsade de pointes. Based on extensive diagnostic workup and exclusion of probable etiologies, she was diagnosed with anti-NMDA receptor encephalitis. To the best of our knowledge, this report represents the first case of anti-NMDA receptor encephalitis complicated by ictal torsades de pointes, leading to cardiac arrest. This paper illustrates that patients with anti-NMDA receptor encephalitis can develop life-threatening cardiac dysrhythmia and cardiac arrest, requiring urgent management. Clinicians should be vigilant for severe autonomic dysfunction as prompt etiology establishment is of paramount importance in these patients.
抗N-甲基-D-天冬氨酸（抗NMDA）受体脑炎是一种罕见的临床病症，通常表现为精神障碍和神经功能缺损。它常与卵巢畸胎瘤相关。尽管这些患者易发生心律失常，但此类并发症通常为自限性。我们在此记录了一名患有附件畸胎瘤的年轻女性的独特病例，她经历了强直阵挛性发作和心脏骤停。心电图显示多形性室性心动过速，符合尖端扭转型室速。基于广泛的诊断检查并排除了可能的病因，她被诊断为抗NMDA受体脑炎。据我们所知，本报告代表了首例抗NMDA受体脑炎并发发作性尖端扭转型室速并导致心脏骤停的病例。本文表明，抗NMDA受体脑炎患者可发生危及生命的心律失常和心脏骤停，需要紧急处理。临床医生应警惕严重的自主神经功能障碍，因为在这些患者中迅速明确病因至关重要。
