Department of Neurology, Graduate School of Medicine, Nippon Medical School, Japan.
Department of Neurology, Tohoku University Graduate School of Medicine, Japan.
Intern Med. 2022 Dec 1;61(23):3585-3588. doi: 10.2169/internalmedicine.9439-22. Epub 2022 May 7.
The pathophysiology of unilateral cortical fluid-attenuated inversion recovery (FLAIR)-hyperintense lesions in anti-myelin oligodendrocyte glycoprotein (MOG)-associated encephalitis with seizures (FLAMES) is unclear. A 26-year-old man was referred because of a seizure. FLAIR showed an increased signal intensity and swelling of the right frontal cortex. His symptoms and imaging abnormalities were improved after intravenous methylprednisolone therapy. MOG antibody was detected both in serum and cerebrospinal fluid (CSF). Therefore, the patient was diagnosed with FLAMES. Myelin basic protein (MBP) was elevated in CSF. The high MBP value in the CSF in the present case suggested that demyelination as well as inflammation can occur in some FLAMES patients.
抗髓鞘少突胶质细胞糖蛋白（MOG）相关脑炎伴发癫痫（FLAMES）患者单侧皮质液体衰减反转恢复（FLAIR）高信号病变的病理生理学机制尚不清楚。一名 26 岁男性因癫痫发作被转来我院。FLAIR 显示右侧额叶皮质信号强度增高和肿胀。他的症状和影像学异常在接受静脉注射甲基强的松龙治疗后得到改善。血清和脑脊液（CSF）中均检测到 MOG 抗体。因此，该患者被诊断为 FLAMES。CSF 中的髓鞘碱性蛋白（MBP）升高。本例中 CSF 中 MBP 值升高提示，一些 FLAMES 患者可能同时发生脱髓鞘和炎症。
