Department of Geriatric Medicine, Qilu Hospital of Shandong University, Jinan, China.
Department of Neurology, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China.
Neurol Sci. 2022 Jan;43(1):525-532. doi: 10.1007/s10072-021-05306-y. Epub 2021 May 12.
Anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor encephalitis is an anti-neuronal surface antigen autoimmune encephalitis and is relatively rare. Our study evaluated a patient who developed anti-AMPA2 receptor encephalitis with memory deficits and refractory focal seizures as paroxysmal jerking on right face as well as dystonic seizure on right hand. On this patient, the combination treatment of levetiracetam, carbamazepine, and clonazepam, monthly periodic intravenous immunoglobin and immunosuppressive therapies for 5 months was not effective for the focal seizures, while his memory loss was slightly improved. However, adjunctive perampanel treatment led to a rapid relief of seizures. Perampanel is suggested in seizures associated with anti-AMPA receptor encephalitis by directly attenuating nerve hyperexcitability caused by glutamate and Ca2+-permeable GluA4 subunit of AMPA receptors.
抗 α-氨基-3-羟基-5-甲基-4-异恶唑丙酸（AMPA）受体脑炎是一种抗神经元表面抗原自身免疫性脑炎，相对较少见。本研究评估了一名患者，该患者患有抗 AMPA2 受体脑炎，表现为记忆缺陷和难治性局灶性癫痫发作，表现为右侧面部阵发性抽搐和右侧手部扭转性发作。针对该患者，使用左乙拉西坦、卡马西平、氯硝西泮联合治疗，每月静脉注射免疫球蛋白和免疫抑制治疗 5 个月，局灶性癫痫发作无效，而记忆丧失略有改善。然而，辅助使用吡仑帕奈治疗可迅速缓解癫痫发作。吡仑帕奈通过直接减弱由谷氨酸和 AMPA 受体的 Ca2+-通透性 GluA4 亚基引起的神经过度兴奋，被推荐用于与抗 AMPA 受体脑炎相关的癫痫发作。
