Kraker Jessica
Jessica Kraker, MD University of Maryland, Department of Neurology, 22 South Greene Street, N4W50, Baltimore, MD 21201, USA.
Curr Treat Options Neurol. 2009 Jan;11(1):46-51. doi: 10.1007/s11940-009-0007-7.
The paraneoplastic syndrome caused by Ma2/Ta antibodies alone (not in conjunction with Ma1 or Ma3 antibodies) varies in presentation from classic limbic encephalitis. The Ma2 syndrome may present with symptoms referable to the brainstem, diencephalon, and limbic system. These clinical symptoms are accompanied by MRI changes and abnormal electroencephalographic findings. It is important to recognize when the encephalitic syndrome is secondary to Ma2 paraneoplastic antibodies, as the patients improve or stabilize most often when the underlying carcinoma is treated. Treatment of the paraneoplastic syndrome begins with recognition of the symptoms, such as memory impairment, seizures, sleep disturbances, bradykinesia or hypokinesia, and eye movement abnormalities. If a primary tumor is discovered during the workup, it should be removed and treated with the most up-to-date oncologic treatment available. In addition to oncologic treatment, the syndrome may be treated with an immunosuppressant regimen to optimize the neurologic outcome. Leaving the patient untreated will result in decline and eventual death from the cancer itself or from complications of the paraneoplastic syndrome.
单独由Ma2/Ta抗体（而非与Ma1或Ma3抗体共同作用）引起的副肿瘤综合征，其临床表现与典型边缘叶脑炎有所不同。Ma2综合征可能表现为涉及脑干、间脑和边缘系统的症状。这些临床症状伴有MRI改变和脑电图异常。认识到脑炎综合征继发于Ma2副肿瘤抗体很重要，因为在治疗潜在癌症时，患者通常会改善或病情稳定。副肿瘤综合征的治疗始于识别症状，如记忆障碍、癫痫发作、睡眠障碍、运动迟缓或运动减少以及眼球运动异常。如果在检查过程中发现原发性肿瘤，应将其切除并用现有的最新肿瘤治疗方法进行治疗。除了肿瘤治疗外，该综合征还可以采用免疫抑制方案进行治疗，以优化神经学预后。不治疗患者将导致病情恶化，最终死于癌症本身或副肿瘤综合征的并发症。
