Neurology Department, Chongqing Medical University, Chongqing, China.
Neurology Department at the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Biomed Res Int. 2020 Apr 14;2020:7506590. doi: 10.1155/2020/7506590. eCollection 2020.
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most common antineuronal antibody encephalitis in autoimmune encephalitis found at present. It has complex clinical manifestations such as psychiatric and behavioral abnormalities, seizures, movement disorders, consciousness, and autonomic dysfunction. The relationship between those manifestations and prognosis is unclear. Electroencephalography (EEG) is gradually becoming useful in the evaluation of the prognosis of anti-NMDAR encephalitis patients, while imaging and antibody testing have a limited prognostic value. Starting the patients on adequate treatments (such as immunotherapy) in a timely fashion has a positive impact on their prognosis. Nevertheless, research on the prognosis of anti-NMDAR encephalitis remains scarce. Here, we review the current advances of prognosis-related research from the clinical manifestations of the disease and auxiliary examinations such as EEG, magnetic resonance imaging (MRI), 18F fluorodeoxyglucose positron emission tomography (FDG-PET), and antibody measurement. In addition, we also discuss the impact of different treatment options on prognosis. In-depth research on the prognosis of patients with anti-NMDAR encephalitis will contribute to a better understanding of this disease, leading to better treatments options and, ultimately, a better prognosis.
抗 N-甲基-D-天冬氨酸受体（NMDAR）脑炎是目前自身免疫性脑炎中最常见的抗神经元抗体脑炎。它具有复杂的临床表现，如精神和行为异常、癫痫发作、运动障碍、意识和自主神经功能障碍。这些表现与预后的关系尚不清楚。脑电图（EEG）在评估抗 NMDAR 脑炎患者的预后方面逐渐变得有用，而影像学和抗体检测对预后的预测价值有限。及时为患者开始进行充分的治疗（如免疫疗法）对其预后有积极影响。然而，关于抗 NMDAR 脑炎预后的研究仍然很少。在这里，我们从疾病的临床表现和辅助检查如脑电图（EEG）、磁共振成像（MRI）、18F 氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）和抗体测量等方面，综述了与预后相关的研究进展。此外，我们还讨论了不同治疗方案对预后的影响。深入研究抗 NMDAR 脑炎患者的预后将有助于更好地了解这种疾病，从而提供更好的治疗选择，并最终获得更好的预后。
