Central neurogenic hyperventilation in anti-NMDA receptor encephalitis

Abstract

Central neurogenic hyperventilation (CNH) is a rare condition that is generally associated with infiltrative tumors of the brainstem. Respiratory dysfunction, particularly central hypoventilation, is common in anti-N-methyl D-aspartate (NMDA) receptor encephalitis. CNH, to the best of our knowledge, has not been de-scribed previously in this disease. A 24-year-old woman was diagnosed with anti-NMDA receptor encephali-tis secondary to ovarian teratoma. In addition to the typical symptoms of the disease, recurrent CNH episodes were observed during the course of the illness, which subsided with midazolam and propofol infusion. Sup-portive and disease-specific treatments, including oopherectomy, plasmapheresis and intravenous immuno-globulin, provided excellent recovery. These observations suggest that NMDA receptors may play a role in the pathophysiology of CNH. © 2012 The Japanese Society of Internal Medicine.