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From Teratoma to Pacemaker: A Rare Case of Anti-N-Methyl-D-Aspartate Receptor (Anti-NMDAR) Encephalitis With Severe Autonomic Instability

Year: 2025

Type: article

Abstract: We report a rare case of an 18-year-old female patient who presented with fever, altered mental status, and seizures and was diagnosed with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis in the setting of a right ovarian teratoma with high-titer antibodies. Despite immunotherapy and tumor resection, she developed severe autonomic instability characterized by recurrent bradycardia, sinus pauses, and an episode of asystole, necessitating temporary transvenous pacing followed by permanent pacemaker (Boston Scientific, USA) implantation. This case highlights the potential for life-threatening cardiac complications in anti-NMDAR encephalitis and emphasizes the need for continuous cardiac monitoring, timely intervention, and multidisciplinary management.

Source: Cureus

DOI: 10.7759/cureus.94591

Authors: Mohamad A Bahrou, Samie Gilani, Mohamed R Labedi, Abdul Moiz Hafiz, Momin Siddique

Institution: SIU Medicine

Language: English

Topic: Autoimmune Neurological Disorders and Treatments

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4415164510