Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan ; Department of Physical Medicine and Rehabilitation, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Neuropsychiatr Dis Treat. 2014 Nov 24;10:2263-7. doi: 10.2147/NDT.S74205. eCollection 2014.
Anti-N-methyl-d-aspartate (anti-NMDA) receptor encephalitis is a newly recognized, potentially fatal, but treatable autoimmune disease. Good outcome predictors include milder severity of symptoms, no need for intensive care unit admission, early aggressive immunotherapy, and prompt tumor removal. We report a case of a young girl aged 3 years 2 months and diagnosed as recalcitrant anti-NMDA receptor encephalitis without any underlying neoplasm. The patient had initial symptoms of behavioral changes that progressed to generalized choreoathetosis and orofacial dyskinesia, which resulted in 6 months of hospitalization in the pediatric intensive care unit. One year after initial onset of the disease, she had only achieved the developmental age of an infant aged 6-8 months in terms of gross and fine motor skills, but she resumed total independence in activities of daily living after receiving extensive immunotherapy and 28 months of rehabilitation. Our brief review will help clinical practitioners become more familiar with this disease and the unique rehabilitation programs.
抗 N-甲基-D-天冬氨酸（anti-NMDA）受体脑炎是一种新认识的、潜在致命但可治疗的自身免疫性疾病。良好的预后预测因素包括症状较轻、无需入住重症监护病房、早期积极的免疫治疗和及时切除肿瘤。我们报告了一例 3 岁 2 个月大的年轻女孩，被诊断为顽固性抗 NMDA 受体脑炎，无任何潜在肿瘤。患者最初出现行为改变的症状，进而发展为全身性舞蹈手足徐动症和口面运动障碍，导致她在儿科重症监护病房住院 6 个月。疾病初始发作 1 年后，她在粗大和精细运动技能方面仅达到婴儿 6-8 个月的发育年龄，但在接受广泛的免疫治疗和 28 个月的康复后，她恢复了日常生活活动的完全自理能力。我们的简要回顾将帮助临床医生更熟悉这种疾病和独特的康复方案。
