Ben Azoun M, Tatencloux S, Deiva K, Blanc P
Service de pédiatrie générale, centre hospitalier intercommunal de Poissy-Saint-Germain-en-Laye, 10, rue du Champ-Gaillard, 78300 Poissy, France.
Service de neuropédiatrie, CHU de Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
Arch Pediatr. 2014 Nov;21(11):1216-9. doi: 10.1016/j.arcped.2014.08.020. Epub 2014 Oct 2.
Although less frequent than viral encephalitis, anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a frequent form of acute pediatric encephalitis. After a prodromal phase of flu-like symptoms, psychiatric symptoms predominate - agitation, anxiety, hallucinations - and can make correct diagnosis more difficult. Also noted are abnormal dyskinesia and dystonia-like movements, partial seizures, difficulties talking or memorizing, and autonomic manifestations. The presentation of two cases of anti-NMDAR encephalitis illustrates the symptoms of this disease. Although the CSF abnormalities are not highly specific of this disease, and MRI most often normal, EEG shows more specific signs. These observations enable us to discuss different treatment options and understand the progression of this disease.
虽然抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎不如病毒性脑炎常见,但它是小儿急性脑炎的常见形式。在出现类似流感症状的前驱期后,精神症状占主导——躁动、焦虑、幻觉——这可能使正确诊断更加困难。还会出现异常的运动障碍和肌张力障碍样运动、部分性癫痫发作、言语或记忆困难以及自主神经表现。两例抗NMDAR脑炎病例的呈现说明了这种疾病的症状。虽然脑脊液异常并非这种疾病的高度特异性表现,且磁共振成像(MRI)大多正常,但脑电图(EEG)显示出更具特异性的体征。这些观察结果使我们能够讨论不同的治疗方案并了解这种疾病的进展。