抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎：病例报告及诊断问题
Anti-NMDAR encephalitis: case report and diagnostic issues.
作者信息
Omura Taishi, Sonoda Seijiro, Nagata Katsuhiro, Okita Taihei, Hoshiai Akira, Sano Hidefumi, Tanaka Yosuke, Tsurukiri Junya, Arai Takao, Ohta Shoichi
机构信息
Department of Emergency and Critical Care Medicine Tokyo Medical University Hachioji Medical Center Tokyo Japan.
Department of Emergency and Critical Care Medicine Tokyo Medical University Tokyo Japan.
出版信息
Acute Med Surg. 2014 Sep 8;2(1):56-59. doi: 10.1002/ams2.57. eCollection 2015 Jan.
CASE
A 20-year-old woman developed acute psychotic symptoms and altered level of consciousness. She presented with neck stiffness, tremulous arms, facial dyskinesia, and distension of the lower abdomen. Pelvic magnetic resonance imaging showed bilateral ovarian teratomas. Anti-N-methyl-D-aspartate receptor antibodies were detected in her cerebrospinal fluid.
OUTCOME
Resection of the tumors and immunotherapy were carried out. She gradually recovered and was discharged with few neurological deficits on the 105th day of hospitalization.
CONCLUSION
Our survey of 63 previous reports describing 92 cases revealed that 21.7% of the patients were sent to emergency departments and 59.8% of the patients were managed in intensive care units. Emergency physicians and intensivists should be aware of this disorder, as they may encounter undiagnosed disorders in patients with epileptic attacks, acute psychotic signs, dyskinesia, or hypoventilation in the course of the illness.
病例
一名20岁女性出现急性精神病症状及意识水平改变。她表现为颈部僵硬、手臂震颤、面部运动障碍以及下腹部膨隆。盆腔磁共振成像显示双侧卵巢畸胎瘤。在她的脑脊液中检测到抗N-甲基-D-天冬氨酸受体抗体。
结果
进行了肿瘤切除及免疫治疗。她逐渐康复，并于住院第105天出院，几乎没有神经功能缺损。
结论
我们对之前63篇描述92例病例的报告进行的调查显示，21.7%的患者被送往急诊科，59.8%的患者在重症监护病房接受治疗。急诊医生和重症监护医生应了解这种疾病，因为在疾病过程中，他们可能会遇到癫痫发作、急性精神病体征、运动障碍或通气不足的未确诊患者。
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