Ueno Shuichi, Hirano Makito, Sakamoto Hikaru, Kusunoki Susumu, Nakamura Yusaku
Department of Neurology, Sakai Hospital, Osaka, Japan ; Department of Neurology, Kinki University Faculty of Medicine, Osaka, Japan.
Department of Neurology, Sakai Hospital, Osaka, Japan.
Case Rep Neurol. 2014 Aug 27;6(2):222-5. doi: 10.1159/000366408. eCollection 2014 May.
We describe the first case of a patient with eyelid tremor probably associated with anti-contactin-associated protein-like 2 (Caspr2) antibody. Encephalitis associated with anti-voltage-gated potassium channel antibody is now attributed to autoantibodies against leucine-rich glioma inactivated 1 (Lgi1) and less frequently against Caspr2. Eyelid tremor or blepharoclonus is a rare or underdiagnosed involuntary movement that has been found in patients with infarction in the thalamus or drug-induced or idiopathic parkinsonism. Since patients with anti-Caspr2 antibody-related encephalitis occasionally have extrapyramidal signs, we speculate that the eyelid tremor was also caused by anti-Caspr2 antibody in our patient. Partial resolution of his symptoms by plasmapheresis also supported the involvement in immunological processes.
我们描述了首例可能与抗接触蛋白相关蛋白样2（Caspr2）抗体相关的眼睑震颤患者。与抗电压门控钾通道抗体相关的脑炎现在归因于针对富含亮氨酸胶质瘤失活1（Lgi1）的自身抗体，而针对Caspr2的情况较少见。眼睑震颤或睑阵挛是一种罕见或诊断不足的不自主运动，见于丘脑梗死、药物性或特发性帕金森病患者。由于抗Caspr2抗体相关脑炎患者偶尔会出现锥体外系症状，我们推测该患者的眼睑震颤也是由抗Caspr2抗体引起的。血浆置换使他的症状部分缓解，这也支持了免疫过程的参与。
