抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎中的边缘系统及新发难治性强直阵挛性癫痫持续状态（NORSE）
Limbic and new onset refractory tonic status epilepticus (NORSE) in anti-NMDAR encephalitis.
作者信息
Kaplan Peter W, Probasco John
机构信息
Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, USA.
Johns Hopkins Hospital, Johns Hopkins University School of Medicine, USA.
出版信息
Clin Neurophysiol Pract. 2017 Jul 1;2:140-143. doi: 10.1016/j.cnp.2017.06.003. eCollection 2017.
AIMS
To present a case of anti-NMDA receptor encephalitis (anti-NMDAR) with new onset refractory non-convulsive status epilepticus (NORSE).
METHODS
Case report with clinical details, MRI, PET, and EEG illustrations.
RESULTS
New onset refractory status epilepticus (NORSE) may arise from anti-NMDAR, and offers diagnostic and treatment challenges for immuno-therapy and refractory status epilepticus. Non-convulsive status epilepticus with generalized fast activity, has not been reported in anti-NMDAR, in NORSE.
CONCLUSIONS
A patient with anti-NMDAR and generalized status with stiffening, right focal weakness, high frequency alpha/beta on EEG, brain FDG-PET/CT changes in the left temporo-parietal regions and cerebellum was presented. We discuss the unique treatment challenges of anti-NMDAR. NORSE and generalized nonconvulsive status epilepticus.
目的
报告一例新发难治性非惊厥性癫痫持续状态（NORSE）的抗N-甲基-D-天冬氨酸受体脑炎（抗NMDAR）病例。
方法
带有临床细节、MRI、PET和脑电图插图的病例报告。
结果
新发难治性癫痫持续状态（NORSE）可能由抗NMDAR引起，对免疫治疗和难治性癫痫持续状态提出了诊断和治疗挑战。抗NMDAR相关的NORSE中尚未有非惊厥性癫痫持续状态伴广泛性快速活动的报道。
结论
本文介绍了一名患有抗NMDAR、出现全身性强直、右侧局灶性无力、脑电图显示高频α/β波、脑FDG-PET/CT显示左侧颞顶叶区域和小脑有变化的患者。我们讨论了抗NMDAR、NORSE和全身性非惊厥性癫痫持续状态独特的治疗挑战。
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