摘要
Abstract
Objective:To investigate the clinical characteristics,diagnosis and treatment of patients with anti-N-methyl-D-aspartate (NMDA)-receptor encephalitis associated with ovarian teratoma.Methods:The clinical data of patients with anti-NMDAR encephalitis associated with ovarian teratoma from Jau.2013 to Jul.2017 were analyzed retrospectively.Results:We ultimately included 12 patients and their average age was 27.4 ±8.4 years.9 patients presented with psychiatric symptoms first,and 3 patients developed with seizure.In the process of disease,all the patients displayed mental and behavioral abnormalities,including bizarre behavior,affective disorder,visual or auditory hallucinations,and persecutory delusion.Other symptoms including decreased level of consciousness (10 cases,83.3％),movement disorders (10 cases,83.3％),epilepsy (9 cases,75.0％),autonomic dysfunction (6 cases,50.0％),central hypoventilation (5 cases,41.7％),speech dysfunction (2 cases,16.7％) and recent memory deficits (2 cases,16.7％) were also observed.Only 1 patients complained prolonged menstrual cycle with no symptoms of abdominal distension or pain.The abnormal auxiliary examinations showed CSF lymphocytic pleocytosis in 5 patients(41.7％),abnormal brain CT/MRI change in 5 patients and elevated serum tumor markers in 8 patients(66.7％).As for the antibodies against NMDAR,all the patients were tested positive in CSF.While 6 patients also carried on the test for antibodies in serum,of which 5(83.3％) tested positive and 1 (16.7％) negative.1 patient refused surgery and died finally.The others who received immunotherapy and operative treatment got a favorable prognosis.Postoperative pathological examination showed 8 cases(72.7％) of mature ovarian teratoma,2 cases(18.2％) of immature teratoma,and 1 case(9.1％) of borderline ovarian teratoma.Conclusions:For those young female patients who presented with psychiatric symptoms or seizure,anti-NMDAR encephalitis should be taken into consideration.And searching for any evidence of ovarian teratoma is necessary.Timely removal of tumor makes better prognosis.关键词
卵巢畸胎瘤/自身免疫性脑炎/抗N-甲基-D-天冬氨酸受体Key words
Teratoma/Autoimmune encephalitis/Anti-N-methyl-D-aspartate receptor分类
医药卫生
