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一名23岁急性精神症状女性抗N-甲基-D-天冬氨酸受体脑炎病例报告。

A case report of anti-NMDA receptor encephalitis in a 23-year-old female with acute psychiatric symptoms.

作者信息

Khatrawi Elham Mohammed, Prajjwal Priyadarshi, Marsool Mohammed Dheyaa Marsool, Das Arpan, Nagre Abhijit, Inban Pugazhendi, Marsool Ali Dheyaa Marsool, Hussin Omniat Amir

机构信息

Department of Basic Medical Sciences College of Medicine, Taibah University Madinah Saudi Arabia.

Neurology Bharati Vidyapeeth Medical College Pune India.

出版信息

Clin Case Rep. 2024 May 7;12(5):e8870. doi: 10.1002/ccr3.8870. eCollection 2024 May.

Abstract

KEY CLINICAL MESSAGE

Prompt identification and management of anti-N-methyl-D-aspartate receptor encephalitis in young patients with acute psychiatric symptoms, seizures, and neurological deficits are crucial. Timely immunomodulatory therapy is essential for positive outcomes and minimizing long-term complications. High suspicion for this rare disorder is necessary for timely diagnosis and optimal care.

ABSTRACT

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is characterized by the presence of antibodies against the NMDA receptor, a crucial component of synaptic signaling. This autoimmune disorder often manifests with psychiatric symptoms, seizures, and neurological deficits. Early diagnosis is essential, as delayed treatment can result in severe complications. In this case, the patient received corticosteroids and intravenous immunoglobulin (IVIG), leading to a successful recovery with no lingering neurological abnormalities. The prompt initiation of treatment highlights the importance of recognizing this condition early. Anti-NMDA receptor encephalitis is a rare autoimmune disorder that presents with a range of neurological symptoms. In this case report, we highlight the significance of early recognition and treatment by discussing the emergency room visit of a 23-year-old woman who presented with acute-onset agitation, disorientation, and seizures. A 23-year-old woman, presented to the emergency room with acute-onset agitation, disorientation, and seizures. Magnetic resonance imaging (MRI) scans revealed temporal lobe signal alterations and electroencephalogram (EEG) showed widespread activity slowing. Importantly, anti-NMDA receptor antibodies were detected in both serum and cerebrospinal fluid, confirming the diagnosis of anti-NMDA receptor encephalitis. This case report underscores the significance of understanding the presentation, diagnosis, and treatment of anti-NMDA receptor encephalitis. Timely recognition and intervention are crucial for achieving favorable outcomes in patients with this rare but clinically important autoimmune disorder. Increased awareness among healthcare professionals is essential to ensure early diagnosis and prompt initiation of appropriate treatment strategies.

摘要

关键临床信息

对于出现急性精神症状、癫痫发作和神经功能缺损的年轻患者,及时识别和治疗抗N-甲基-D-天冬氨酸(NMDA)受体脑炎至关重要。及时进行免疫调节治疗对于取得良好预后及将长期并发症降至最低至关重要。高度怀疑这种罕见疾病对于及时诊断和优化治疗至关重要。

摘要

抗N-甲基-D-天冬氨酸(NMDA)受体脑炎的特征是存在针对NMDA受体的抗体,NMDA受体是突触信号传导的关键组成部分。这种自身免疫性疾病常表现为精神症状、癫痫发作和神经功能缺损。早期诊断至关重要,因为治疗延迟会导致严重并发症。在本病例中,患者接受了皮质类固醇和静脉注射免疫球蛋白(IVIG)治疗,成功康复且无持续的神经功能异常。及时开始治疗凸显了早期识别这种疾病的重要性。抗NMDA受体脑炎是一种罕见的自身免疫性疾病,表现为一系列神经症状。在本病例报告中,我们通过讨论一名23岁女性因急性起病的躁动、定向障碍和癫痫发作到急诊室就诊的情况,强调了早期识别和治疗的重要性。一名23岁女性因急性起病的躁动、定向障碍和癫痫发作到急诊室就诊。磁共振成像(MRI)扫描显示颞叶信号改变,脑电图(EEG)显示广泛的活动减慢。重要的是,在血清和脑脊液中均检测到抗NMDA受体抗体,确诊为抗NMDA受体脑炎。本病例报告强调了了解抗NMDA受体脑炎的临床表现、诊断和治疗的重要性。对于这种罕见但临床上重要的自身免疫性疾病患者,及时识别和干预对于取得良好预后至关重要。提高医护人员的认识对于确保早期诊断和及时启动适当的治疗策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02af/11077172/50a0ffecaaeb/CCR3-12-e8870-g002.jpg

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