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肌阵挛性癫痫持续状态作为 caspr2 抗体相关自身免疫性脑炎的表现。

Myoclonic status epilepticus as a presentation of caspr2 antibody-associated autoimmune encephalitis.

机构信息

Department of Neurology, Westmead Hospital, and Sydney Medical School, University of Sydney, Neuroimmunology group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital at Westmead.

Department of Neurology, Westmead Hospital, and Sydney Medical School, University of Sydney.

出版信息

Epileptic Disord. 2014 Dec;16(4):477-81. doi: 10.1684/epd.2014.0707.

Abstract

We present a case of autoimmune encephalitis associated with antibodies targeting contact in-associated protein-like 2. This case is notable because of the presentation with myoclonic status epilepticus and the prolonged clinical course of refractory seizures, which are demonstrated in the accompanying videos, and not previously associated with this condition. Treatment with prednisone, intravenous immunoglobulin, plasma exchange, rituximab, cyclophosphamide, and mycophenolate mofetil resulted in significant functional improvement. Historically, myoclonic status epilepticus is associated with a grave prognosis and minimal chance of meaningful recovery. This case demonstrates that autoimmune encephalitis remains an important differential diagnosis in patients with such a presentation, and that early recognition and the appropriate institution of immunotherapy can result in seizure control and functional recovery. [Published with video sequences].

摘要

我们报告一例与接触相关蛋白样 2 抗体相关的自身免疫性脑炎。本病例的显著特点为肌阵挛性癫痫持续状态发作以及与之相关的、在随附视频中显示的、长时间且对抗癫痫药物耐药的癫痫发作,这在之前的报道中尚未出现过。我们对该患者使用泼尼松、静脉注射免疫球蛋白、血浆置换、利妥昔单抗、环磷酰胺和霉酚酸酯进行治疗,取得了显著的功能改善效果。既往研究表明,肌阵挛性癫痫持续状态与预后极差以及恢复可能性极小相关。本病例表明,对于此类发作的患者,自身免疫性脑炎仍是一个重要的鉴别诊断,早期识别并采取适当的免疫治疗可控制癫痫发作并恢复其功能。[附有视频序列]。

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