Hollódy Katalin, Csábi Györgyi, Láng Anikó, Rózsai Barnabás, Komáromy Hedvig, Bors László, Illés Zsolt
Pécsi Tudományegyetem, Klinikai Központ, Gyermekklinika.
Ideggyogy Sz. 2011 Mar 30;64(3-4):119-25.
In the majority of cases, anti-NMDA (N-methyl-D-aspartate) receptor encephalitis is a severe, but treatable disorder, therefore early diagnosis and adequate therapy are very important. It should be suspected in children and young women, who develop acute psychiatric symptoms and seizures. During the course of the disease severe encephalopathy, agitation, hallucinations, orofacial dyskinesias, prolonged cognitive disturbance, autonomic symptoms can be observed and akinetic mutism develops. EEG shows diffuse slowing. Brain MRI is normal or unspecific. Elevated protein, pleiocytosis and oligoclonal bands can be present in the CSF Detection of NMDA-receptor antibodies in sera or CSF confirms diagnosis. We present the case of a 15-year-old girl, who fully recovered within two months after steroid treatment and repeated plasma exchange. Ovarian teratoma has not been detected.
在大多数情况下,抗N-甲基-D-天冬氨酸(NMDA)受体脑炎是一种严重但可治疗的疾病,因此早期诊断和适当治疗非常重要。对于出现急性精神症状和癫痫发作的儿童及年轻女性,应怀疑患有此病。在疾病过程中,可观察到严重脑病、激越、幻觉、口面部运动障碍、长期认知障碍、自主神经症状,进而发展为运动不能性缄默症。脑电图显示弥漫性减慢。脑部磁共振成像(MRI)正常或无特异性表现。脑脊液中可出现蛋白升高、细胞增多和寡克隆带。血清或脑脊液中NMDA受体抗体的检测可确诊。我们报告一例15岁女孩的病例,她在接受类固醇治疗和重复血浆置换后两个月内完全康复。未检测到卵巢畸胎瘤。