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喉痉挛作为抗N-甲基-D-天冬氨酸受体脑炎患者的罕见表现:一例报告

Laryngospasm as an uncommon presentation in a patient with anti-N-methyl-D-aspartate receptor encephalitis: A case report.

作者信息

Wang Lu, Su Hong-Jun, Song Guan-Jie

机构信息

Department of Neurology, Tianjin Baodi Hospital, Tianjin 301800, China.

出版信息

World J Clin Cases. 2023 Jul 16;11(20):4961-4965. doi: 10.12998/wjcc.v11.i20.4961.

Abstract

BACKGROUND

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune disorder. The symptoms of anti-NMDAR encephalitis include behavioral problems, speech problems, psychosis, seizures, and memory deficits, among others. However, laryngospasm is rare. We present the case of a patient with anti-NMDAR antibodies and severe laryngospasms.

CASE SUMMARY

The patient was a 15-year-old female with normal psychomotor development. She was initially admitted to our neurological intensive care unit with seizures. She received anti-epilepsy treatment, and the seizures disappeared. However, 2 wk later, she developed behavioral problems and speech impairment. Then, she developed severe laryngospasms, which were treated with intubation and a tracheotomy. Antibodies against the NMDAR were detected in the patient's cerebrospinal fluid. Therefore, she was diagnosed with anti-NMDAR encephalitis. In addition, she received intravenously administered immunoglobulins, and methylprednisolone was administered. The patient's symptoms gradually improved, and she was discharged from our hospital. Approximately 9 mo later, the patient could speak sentences, walk independently, and carry out activities of daily living independently. Through our case report, we highlighted laryngospasm as an uncommon presentation in patients with anti-NMDAR encephalitis.

CONCLUSION

Laryngospasm may be an uncommon clinical manifestation of anti-NMDAR encephalitis.

摘要

背景

抗N-甲基-D-天冬氨酸受体(抗NMDAR)脑炎是一种罕见的自身免疫性疾病。抗NMDAR脑炎的症状包括行为问题、言语问题、精神病、癫痫发作和记忆缺陷等。然而,喉痉挛较为罕见。我们报告一例患有抗NMDAR抗体且伴有严重喉痉挛的患者。

病例摘要

该患者为一名15岁女性,精神运动发育正常。她最初因癫痫发作入住我们的神经重症监护病房。她接受了抗癫痫治疗,癫痫发作消失。然而,2周后,她出现了行为问题和言语障碍。随后,她出现了严重的喉痉挛,通过插管和气管切开术进行治疗。在患者的脑脊液中检测到抗NMDAR抗体。因此,她被诊断为抗NMDAR脑炎。此外,她接受了静脉注射免疫球蛋白,并给予了甲泼尼龙。患者的症状逐渐改善,随后出院。大约9个月后,患者能够说出句子,独立行走,并能独立进行日常生活活动。通过我们的病例报告,我们强调了喉痉挛是抗NMDAR脑炎患者中一种不常见的表现。

结论

喉痉挛可能是抗NMDAR脑炎一种不常见的临床表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff10/10424042/80968ce1c542/WJCC-11-4961-g001.jpg

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