Bradley Lloyd
Donald Wilson House Neurological Rehabilitation Centre, Western Sussex Hospitals Trust , Chichester, West Sussex , UK.
Brain Inj. 2015;29(6):785-8. doi: 10.3109/02699052.2015.1004741. Epub 2015 Jan 27.
Anti-NMDA (N-methyl D-Aspartate) encephalitis is an autoimmune disorder of the central nervous system which presents acutely with seizures, disturbances in consciousness and behavioural change. Although there is an increasing amount of information about the diagnosis and acute treatment strategies, little is known about rehabilitation needs and outcomes for this patient group.
This study presents a 52-year old woman who initially presented with generalized seizures and drowsiness. She was admitted to hospital where autoimmune encephalitis was diagnosed based on a positive serum anti-NMDA antibody titre. When medically stabilized, she was transferred to a specialist neurorehabilitation unit for ongoing care. Her main clinical issues were around behavioural disturbance, communication, continence, mobility and cognition. A multi-disciplinary approach was taken to her problems and she was eventually discharged back to community living having made substantial improvements in all domains of functioning. The clinical challenges encountered throughout her rehabilitation and the approach to ameliorating these is described.
Although having a relatively rare diagnosis, the specific rehabilitation needs of this patient were met through an existing specialist neurorehabilitation service. A broader case series is required to determine needs and effective approaches across this patient group as a whole.
抗N-甲基-D-天冬氨酸（NMDA）受体脑炎是一种中枢神经系统自身免疫性疾病，急性起病，表现为癫痫发作、意识障碍和行为改变。尽管关于该疾病的诊断和急性治疗策略的信息越来越多，但对于这一患者群体的康复需求和预后却知之甚少。
本研究介绍了一名52岁女性，最初表现为全身性癫痫发作和嗜睡。她被收治入院，根据血清抗NMDA抗体滴度呈阳性诊断为自身免疫性脑炎。病情稳定后，她被转至专科神经康复单元接受持续治疗。她的主要临床问题涉及行为障碍、沟通、大小便控制、活动能力和认知。针对她的问题采取了多学科方法，最终她出院回到社区生活，各功能领域均有显著改善。本文描述了她在整个康复过程中遇到的临床挑战以及应对这些挑战的方法。
尽管该疾病诊断相对罕见，但通过现有的专科神经康复服务满足了该患者的特定康复需求。需要更广泛的病例系列研究来确定整个这一患者群体的需求和有效治疗方法。
