临床误诊误治2017，Vol.30Issue(7)：10-13,4.DOI:10.3969/j.issn.1002-3429.2017.07.003
抗NMDA受体脑炎误诊分析并文献复习
Misdiagnosis Analysis of a Patient with Anti-N-methyl-D-Aspartate Receptor Encephalitis and Literature Review
李晨霞 1马康平 2梁乐 3倪俊 1章颖 1付静 3李云林2
作者信息
- 1. 100080 北京,北京市海淀医院妇产科
- 2. 100203 北京,首都儿科研究所附属儿童医院神经外科
- 3. 100080 北京,北京市海淀医院病理科
- 折叠
摘要
Abstract
Objective To investigate clinical features of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis in order to improve the diagnosis and treatment.Methods Clinical data one of a patient with NMDA receptor encephalitis was retrospectively analyzed, and related literature was also reviewed.Results This young female was admitted for intermittent loss of consciousness associated by limb vellicating for 6 days, and the effect for epileptic seizure was poor in other hospital.After transferring to our hospital, electroencephalography (EEG) examination showed that bilateral foreheads temporal intermittent slow waveform, and no obvious abnormalities was found by brain magnetic resonance imaging (MRI) examination, so the primary diagnosis was epilepsy.Levetiracetam was given orally.During the course of treatment, she had fever, abnormally mental behavior, personality change, hallucinations and orofacial involuntary movement.Pelvic imaging examination suggested ovarian teratoma, and NMDA receptor encephalitis was highly suspected, and then the result of anti-NMDA receptor antibody examination for serum and cerebrospinal fluid was positive.NMDA receptor encephalitis was confirmed.The teratoma was exsected by surgery on the basis of immunotherapy, and the patient's neural and mental symptoms were disappeared, and the patient recovered completely and was discharged.Conclusion Young females with ovarian embryoma have unknown causes of mental symptom and movement disorders, the anti-NMDA receptor encephalitis should be highly considered, and anti-NMDA receptor antibody examination for serum and cerebrospinal fluid can confirmed the diagnosis.关键词
抗N-甲基-D-门天冬氨酸受体脑炎/误诊/癫痫/畸胎瘤Key words
Anti-N-methyl-D-aspartate receptor encephalitis/Misdiagnosis/Epilepsy/Teratoma分类
医药卫生引用本文复制引用
李晨霞,马康平,梁乐,倪俊,章颖,付静,李云林..抗NMDA受体脑炎误诊分析并文献复习[J].临床误诊误治,2017,30(7):10-13,4.
