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SUMMARY
Management of cases of anti- N- methyl- D- aspartate
(NMDA) antibody- mediated encephalitis is very
challenging to anaesthesiologists as this receptor
is the target of many anaesthetics. We report a
woman diagnosed with anti- NMDA antibody-
mediated encephalitis posted for laparotomy. She
presented with generalised tonic- clonic seizures.
Testing revealed anti- NMDA antibodies and anti-
SOX antibodies. Ultrasonography of the abdomen
showed a right adnexal cystic lesion; hence, the
patient was taken up for right ovarian cystectomy
after obtaining high- risk consent. A combination
of total intravenous anaesthesia with endotracheal
intubation under bispectral index monitoring
and bilateral transversus abdominis plane block
for postoperative analgesia was administered.
Postoperatively, there was no excessive drowsiness
or hypoventilation. Prioritising careful monitoring
and tailored anaesthesia techniques to minimise the
risk of triggering neurological exacerbations while
ensuring optimum surgical conditions are met is of
paramount importance. Meticulous planning and
careful use of resources enabled the administration
of safe anaesthesia.