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抗N-甲基-D-天冬氨酸受体脑炎的临床特征及伴发的癫痫发作

[Clinical features of anti-N-methyl-D-aspartate receptor encephalitis and the concomitant seizure].

作者信息

Wu Lingchao, Hu Chongyu, Long Lili, Long Xiaoyan, Li Jing, Liu Weiping, Bi Fangfang, Xiao Bo

机构信息

Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, China.

Department of Neurology, Hunan Provincial People's Hospital, Changsha 410005, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019 May 28;44(5):544-548. doi: 10.11817/j.issn.1672-7347.2019.05.011.

DOI:10.11817/j.issn.1672-7347.2019.05.011
PMID:31303618
Abstract

To investigate the clinical features, auxiliary examination and characteristics for anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis and its concomitant seizure.
 Methods: A total of 20 patients diagnosed as anti-NMDAR encephalitis were enrolled from January 2016 to September 2018 in Xiangya Hospital. The data including the clinical features, auxiliary examination, characteristics of seizure, treatment and prognosis were collected. The discharged patients were followed up for half a year.
 Results: The initial symptom in patients with anti-NMDAR encephalitis were mainly psychiatric symptom and seizure. Most of the EEG result were diffused slow waves. The mainly type of seizure in patients with anti-NMDAR encephalitis showed generalized tonic-clonic seizure. Patients occurred consciousness during the onset of the disease. MRI showed that patients with temporal lobe were more inclined to occur seizure than patients with anti-NMDAR encephalitis (P<0.05). After standardized treatment, 20 patients showed a significant improvement in modified Rankin Scale (mRS) scores and the seizure was under control within half a year. 
 Conclusion: Patients with temporal lobe affected in MRI should pay attention to the possibility of seizure occurrence. Anti-epileptic drugs and immunotherapy should be used promptly in patient with seizure. After standardized treatment, the prognosis of patients will be mostly good.

摘要

探讨抗N-甲基-D-天冬氨酸受体(anti-NMDAR)脑炎及其伴发癫痫的临床特征、辅助检查及特点。方法:选取2016年1月至2018年9月在湘雅医院确诊为anti-NMDAR脑炎的患者20例,收集其临床特征、辅助检查、癫痫特点、治疗及预后等资料,对出院患者随访半年。结果:anti-NMDAR脑炎患者首发症状以精神症状及癫痫为主,脑电图结果多为弥漫性慢波,anti-NMDAR脑炎患者癫痫发作类型以全身强直-阵挛发作为主,发病时多有意识障碍,MRI显示颞叶受累的anti-NMDAR脑炎患者较易发生癫痫(P<0.05)。经规范治疗后,20例患者改良Rankin量表(mRS)评分明显改善,癫痫在半年内得到控制。结论:MRI显示颞叶受累的患者应注意癫痫发生的可能性,癫痫患者应及时应用抗癫痫药物及免疫治疗,经规范治疗后患者预后大多良好。

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引用本文的文献

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Front Neurol. 2022 Jan 5;12:801289. doi: 10.3389/fneur.2021.801289. eCollection 2021.