摘要
Abstract
Objective To investigate clinical characteristics of the resistance of N-methyl-D-aspartate ( N-methyl-D-as-parate, NMDA) receptor encephalitis patients, the cause and the key points of the differential diagnosis of viral encephalitis. Methods Clinical data of 30 cases NMDA receptor encephalitis admitted to the Hospital of Peking Union Medical College for emergency diagnosis and treatment during January 2011 and July 2014 were retrospectively analyzed, including the first clinical manifestation, whether with teratoma and other parts of the infection, cerebrospinal fluid virology and immunology specific anti-body test results. Results The early manifestations of 30 cases of early manifestations were not specific. Depending on the fre-quency, they were the frequency of mental behavior performance, seizures, or limb involuntary movement, fever, headache, consciousness. Expet 1 confirmed case by PUMC hospital, 29 cases were misdiagnosed at other local hospitals as viral encephali-tis, antiviral treatment, mental illness and epilepsy, or poor epilepsy therapy effect, or disease progression positive test of anti NMDA antibody confirmed diagnosis, and the first visit misdiagnosis rate was 100%, and the diagnosis time was (270. 15 ± 114. 97)d. Corticosteroids and gamma globulin and immunosuppressant therapy was given, and in case of merger teratoma, sur-gical resection was applied. There was a certain correlation between prognosis and progression. Conclusion Clinicians should be aware of common early clinical manifestations of NMDA receptor encephalitis, early NMDA receptor antibody screening is rec-ommended in high-risk groups for differential diagnosis as the conventional detection method in order to give early diagnosis and early treatment for patients for better prognosis.关键词
N-甲基天冬氨酸/抗N-甲基-D-门冬氨酸受体脑炎/误诊/脑炎,病毒性/精神病/癫痫Key words
N-methyl-D-aspartate/Anti-NMDA receptor encephalitis/Misdiagnosis/Encephalitis, viral/Mental ill-ness/Epilepsy分类
医药卫生
