国际神经病学神经外科学杂志2017，Vol.44Issue(4)：361-364,4.DOI:10.16636/j.cnki.jinn.2017.04.004
抗N-甲基-D-天冬氨酸受体抗体脑炎复发的临床特征
Clinical relapse of anti-N-methyl-D-aspartate receptor encephalitis
张元杏 1王灿灿 1杨辉丽 1吴颖颖 1刘慧勤 1高鑫雅 1时英英 1臧卫周 1张杰文1
作者信息
- 1. 郑州大学人民医院神经内科,河南省郑州市450003
- 折叠
摘要
Abstract
Objective To investigate the clinical features,diagnosis,and therapeutic strategies of relapsing anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.Methods A retrospective analysis was performed on 10 relapsing patients from 57 patients with antiNMDAR encephalitis who were diagnosed and treated in the People's Hospital of Zhengzhou University from May 2013 to February 2017 to investigate their clinical symptoms,laboratory examinations,radiological features,and immunotherapy.Results In the 10 relapsing patients,there were 5 males and 5 females,with a mean age of 27.5 years.Totally,14 relapses occurred in the 10 cases,with 2-3 relapses in 2 cases,and the mean interval between two relapses was 7.1 months (1-19 months).The clinical symptoms of the relapses were epilepsy (8/14),mental and behavioral disorders (8/14),and atypical relapsing symptoms such as dizziness,ataxia,and diplopia (1/14).Anti-NMDAR detection was performed in the relapsing patients (13 relapses).The positive detection rate was 100％ (13/13) for cerebrospinal fluid samples and 69％ (9/13) for serum samples.Immunotherapy was effective for the 13 relapses,and was refused by 1 relapsing case.These 10 patients underwent a follow up of mean 18.9 months,with complete recovery in 3 cases,mild sequelae in 4 cases,and severe sequelae in 3 cases.Conclusions Both typical and atypical symptoms are found when relapse occurs in patients with anti-NMDAR encephalitis.Test for anti-NMDAR antibody may help to make an early diagnosis.An active immunotherapy strategy may lead to a better prognosis.关键词
抗N-甲基-D-天冬氨酸受体抗体脑炎/复发/免疫治疗Key words
anti-N-methyl-D-aspartate receptor encephalitis/relapse/immunotherapy引用本文复制引用
张元杏,王灿灿,杨辉丽,吴颖颖,刘慧勤,高鑫雅,时英英,臧卫周,张杰文..抗N-甲基-D-天冬氨酸受体抗体脑炎复发的临床特征[J].国际神经病学神经外科学杂志,2017,44(4):361-364,4.
