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自身免疫性脑炎:临床表现、诊断与治疗

Autoantibody Encephalitis: Presentation, Diagnosis, and Management.

作者信息

Lancaster Eric

机构信息

Department of Neurology, The University of Pennsylvania, Philadelphia, PA, USA.

出版信息

J Clin Neurol. 2022 Jul;18(4):373-390. doi: 10.3988/jcn.2022.18.4.373.

Abstract

Autoantibody encephalitis causes distinct clinical syndromes involving alterations in mentation, abnormal movements, seizures, psychiatric symptoms, sleep disruption, spasms, and neuromyotonia. The diagnoses can be confirmed by specific antibody tests, although some antibodies may be better detected in spinal fluid and others in serum. Each disorder conveys a risk of certain tumors which may inform diagnosis and be important for treatment. Autoantibodies to receptors and other neuronal membrane proteins are generally thought to be pathogenic and result in loss of function of the targets, so understanding the pharmacology of the receptors may inform our understanding of the syndromes. Patients may be profoundly ill but the syndromes usually respond to immune therapy, although there are differences in the types of immune therapy that are thought to be most effective for the various disorders.

摘要

自身抗体性脑炎可引发独特的临床综合征,包括精神状态改变、异常运动、癫痫发作、精神症状、睡眠障碍、痉挛和神经性肌强直。尽管有些抗体在脑脊液中检测效果更佳,而另一些在血清中检测效果更佳,但通过特定抗体检测可确诊。每种疾病都伴有某些肿瘤的风险,这可能有助于诊断且对治疗很重要。针对受体和其他神经元膜蛋白的自身抗体通常被认为具有致病性,并导致靶标功能丧失,因此了解受体的药理学特性可能有助于我们理解这些综合征。患者可能病情严重,但这些综合征通常对免疫治疗有反应,尽管对于各种疾病,人们认为最有效的免疫治疗类型存在差异。

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