We present the case of a 65-year-old female, a known case of Turner syndrome with multiple co-morbidities, namely, long-standing coronary triple vessel disease, diabetes, hypertension, hypothyroidism, gastro-esophageal reflux disease, psychiatric illness, severe osteoporosis, and severe sensorineural hearing loss. She was scheduled to undergo repair of an intertrochanteric fracture of the femur. Evaluation of her symptoms revealed episodes of autonomic dysfunction in relation to stressful events and illness, characterized by hypotension and tachycardia, which were responsive to fluids. Her medications at the time included clopidogrel, ecosprin, ramipril, metoprolol, atorvastatin, quetiapine, zoledronic acid, vitamin D3, prednisolone, L-thyroxine, metformin, and multivitamins. She was admitted to the neurology department with complaints of hallucinations, memory disturbances, and agitation. During the course of her hospital stay, she experienced a fall in the bathroom that resulted in a fracture of the right femur. Her cerebrospinal fluid examination was within normal limits; magnetic resonance imaging Letter to the Editor Anesthesia management in a case of Turner syndrome with anti-NMDA limbic encephalitis and multiple co-morbidities for repair of fracture femur