ANAESTHETIC MANAGEMENT OF NMDA RECEPTOR ENCEPHALITIS IN A 19-YEAR-OLD PATIENT WITH OVARIAN DERMOID POSTED FOR CYSTECTOMY- A RARE CASE REPORT
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 16
Abstract
PRESENTATION OF CASE A 19-year-old female patient presented with auditory hallucinations along with unusual phobias and abnormal behaviour for 1 year. DIFFERENTIAL DIAGNOSIS The differential diagnosis included psychosis, anxiety disorder, phobia, obsessive compulsive disorder, dissociative disorder and schizophrenia. CLINICAL DIAGNOSIS The patient was apparently well 1 year back when she started having auditory hallucinations along with unusual phobias and abnormal behaviour. She was diagnosed as dissociative disorder in Safdarjung hospital and was put on sedatives. After 2 days she was referred to RML hospital for admission where she was admitted for a period for 10 days. After 10 days of admission, she had sudden onset seizures and was started on sodium valproate for the same. She also had some autonomic disturbances and was then transferred to medicine ward for further management. Her serum was tested for NMDA serology and the test turned out to be positive. Abdominal ultrasound revealed dermoid cyst in ovary. She was given a course of intravenous immunoglobulin for 5 days and then the patient was shifted to AIIMS for further management. In AIIMS she underwent CSF serology which turned out to be positive. MRI brain was normal. PET scan revealed dermoid ovary of 15cm. She was started on Tab. Wysolone, Tab. Mycophenytyl, Tab. Quitipine, Tab. Calflash, Tab. Tegrital. She was scheduled for laparotomy and cystectomy for which patient was transferred to Safdarjung hospital.
Authors and Affiliations
Pratibha Mudgal, Shilpee Kumari
Keywords
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- EP ID EP556233
- DOI 10.18410/jebmh/2018/294
- Views 63
- Downloads 0
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