Shimokaze Tomoyuki, Kato Mitsuhiro, Yoshimura Yozo, Takahashi Yukitoshi, Hayasaka Kiyoshi
Department of Pediatrics, Yamagata Prefectural Shinjo Hospital, Shinjo, Japan.
Brain Dev. 2007 May;29(4):224-6. doi: 10.1016/j.braindev.2006.08.011. Epub 2006 Sep 27.
A 13-year-old boy presented with a six-day history of headache and gradually developed severe meningeal irritation symptoms. Brain magnetic resonance imaging revealed left cerebellar swelling and obstructive hydrocephalus. Then he showed transient ataxia, but recovered without any sequelae soon after high dose steroid therapy. IgG type of autoantibodies against glutamate receptor delta2 (GluRdelta2) were detected in the serum, but not in the cerebrospinal fluid in his early clinical course. It was suggested that autoantibodies against GluRdelta2 might not have injured the tissue due to the immunological action, but might be induced as a consequence of cerebellar damage. Early steroid treatment for acute cerebellitis might have been effective to prevent the progress of the disease and improve the prognosis.
一名13岁男孩出现头痛症状6天,并逐渐出现严重的脑膜刺激症状。脑部磁共振成像显示左小脑肿胀和梗阻性脑积水。随后他出现短暂性共济失调,但在高剂量类固醇治疗后很快康复,未留下任何后遗症。在其临床病程早期,血清中检测到针对谷氨酸受体δ2(GluRδ2)的IgG型自身抗体,但脑脊液中未检测到。提示针对GluRδ2的自身抗体可能并非因免疫作用损伤组织,而是小脑损伤的结果。早期使用类固醇治疗急性小脑炎可能有效预防疾病进展并改善预后。