Goldberg E M, Taub K S, Kessler S K, Abend N S
Department of Neurology, The Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Neuropediatrics. 2011 Oct;42(5):188-90. doi: 10.1055/s-0031-1295408. Epub 2011 Nov 22.
A previously healthy 9-year-old girl presented to an emergency department (ED) with headache, dizziness, blurry vision, and abnormal visual perceptions. She was diagnosed with migraine, treated symptomatically, and discharged. Over the course of days, she became progressively somnolent, and returned to the ED, where she was found to have a right inferior quadrantanopsia and sixth nerve palsy. Magnetic resonance imaging (MRI) of the brain showed gyral swelling of the left parieto-occipital lobe. Continuous electroencephalogram (EEG) monitoring revealed focal non-convulsive status epilepticus (NCSE) in the left occipital region. Cerebrospinal fluid (CSF) was positive for antibodies directed against the N-methyl-d-aspartate receptor (NMDAR). This case is the first report of anti-NMDAR encephalitis presenting with focal non-convulsive status epilepticus (NCSE).
一名既往健康的9岁女孩因头痛、头晕、视力模糊和视觉感知异常就诊于急诊科。她被诊断为偏头痛，接受了对症治疗后出院。在接下来的几天里，她逐渐变得嗜睡，并返回急诊科，在那里被发现有右下方象限盲和第六神经麻痹。脑部磁共振成像（MRI）显示左顶枕叶脑回肿胀。持续脑电图（EEG）监测显示左枕叶区域存在局灶性非惊厥性癫痫持续状态（NCSE）。脑脊液（CSF）中抗N-甲基-D-天冬氨酸受体（NMDAR）抗体呈阳性。该病例是首例以局灶性非惊厥性癫痫持续状态（NCSE）为表现的抗NMDAR脑炎报告。
