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抗 N-甲基-D-天冬氨酸受体脑炎与抗髓鞘少突胶质细胞糖蛋白抗体相关疾病共存:病例报告。

Repeated anti-N-methyl-D-aspartate receptor encephalitis coexisting with anti-myelin oligodendrocyte glycoprotein antibody-associated diseases: A case report.

机构信息

Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan.

Department of General Medicine, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan.

出版信息

Mult Scler Relat Disord. 2019 Oct;35:182-184. doi: 10.1016/j.msard.2019.08.002. Epub 2019 Aug 3.

Abstract

The coexistence of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and anti-myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated diseases has been reported. We report the case of a 36-year-old woman who presented with repeated typical anti-NMDAR encephalitis coexisting with unusual symptoms not consistent with anti-NMDAR encephalitis. Apart from the anti-NMDAR encephalitis, her first episode was characterized by balance disability with bilateral medial frontal cortical lesions, suggesting the involvement of the cortico-reticular projections and the basal ganglia-brainstem projections. The second episode presented with Broca's aphasia caused by involvement of the Broca's area and lower part of the precentral gyrus. The detection of MOG-Ab in both episodes suggested the coexistence of MOG-Ab-associated diseases. Thus, an evaluation of MOG-Ab should be considered when anti-NMDAR encephalitis presenting with atypical symptoms is encountered.

摘要

抗 N-甲基-D-天冬氨酸受体(NMDAR)脑炎与抗髓鞘少突胶质细胞糖蛋白抗体(MOG-Ab)相关疾病共存已有报道。我们报告了一例 36 岁女性病例,其表现为反复出现典型的抗 NMDAR 脑炎,同时伴有不符合抗 NMDAR 脑炎的不常见症状。除抗 NMDAR 脑炎外,她的首次发作表现为平衡障碍,双侧额内侧皮质病变,提示皮质网状投射和基底节-脑干投射受累。第二次发作表现为布罗卡区和中央前回下部受累引起的布罗卡失语症。两次发作均检测到 MOG-Ab,提示 MOG-Ab 相关疾病共存。因此,当遇到表现为不典型症状的抗 NMDAR 脑炎时,应考虑进行 MOG-Ab 评估。

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