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抗N-甲基-D-天冬氨酸受体脑炎中持续存在的极端δ波：它是否预示预后不良？

Persistent extreme delta brush in anti-NMDA-receptor encephalitis: Does it portend a poor prognosis?

作者信息

Sankaranarayanan Muthukani, Shah Shalin, Thomas Pravin, Kannoth Sudheeran, Radhakrishnan Kurupath

机构信息

Department of Neurology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.

出版信息

Epilepsy Behav Rep. 2019;12:100324. doi: 10.1016/j.ebr.2019.100324. Epub 2019 Jun 6.

DOI:10.1016/j.ebr.2019.100324
PMID:31346587
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6657531/
Abstract

We describe an adolescent girl with non-paraneoplastic anti-NMDA-receptor encephalitis (ANMDARE), who despite persistence of the extreme delta brush (EDB) pattern for nearly 2 years in her serial EEGs, she exhibited a speedy and sustained response to immunotherapy. To the best of our knowledge, our patient had the longest persistence of the EDB pattern on EEG reported to date. Our patient illustrates that, although presence of EDB supports the diagnosis of ANMDARE, its presence and persistence may not be a reliable predictor of response to immunotherapy and overall clinical prognosis.

摘要

我们描述了一名患有非副肿瘤性抗N-甲基-D-天冬氨酸受体脑炎（ANMDARE）的青春期女孩，尽管她连续脑电图中极端δ刷（EDB）模式持续了近2年，但她对免疫治疗表现出快速且持续的反应。据我们所知，我们的患者是迄今为止报告的脑电图中EDB模式持续时间最长的。我们的患者表明，虽然EDB的存在支持ANMDARE的诊断，但其存在和持续时间可能不是免疫治疗反应和总体临床预后的可靠预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/e56b033e2cf7/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/189aa5b9e815/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/71687cbde944/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/ee2ecf7292a7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/332645a94c56/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/e56b033e2cf7/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/189aa5b9e815/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/71687cbde944/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/ee2ecf7292a7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/332645a94c56/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e33/6657531/e56b033e2cf7/gr4.jpg

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Clin Neurophysiol. 2019 Feb;130(2):289-296. doi: 10.1016/j.clinph.2018.10.017. Epub 2018 Nov 29.
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EEG findings in NMDA encephalitis - A systematic review.NMDA 脑炎的脑电图表现——一项系统综述。
Seizure. 2019 Feb;65:20-24. doi: 10.1016/j.seizure.2018.12.015. Epub 2018 Dec 19.
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Clinical variability of children with anti-N-methyl-D-aspartate receptor encephalitis in southern Brazil: a cases series and review of the literature.
巴西南部抗 N-甲基-D-天冬氨酸受体脑炎患儿的临床变异性：病例系列及文献复习。
Neurol Sci. 2019 Feb;40(2):351-356. doi: 10.1007/s10072-018-3648-z. Epub 2018 Nov 20.
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Neurocase. 2018 Aug;24(4):188-194. doi: 10.1080/13554794.2018.1524915. Epub 2018 Oct 6.
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