鞘内注射治疗抗N-甲基-D-天冬氨酸受体脑炎：难治性病例的一种有前景的方法。
Intrathecal treatment of Anti-N-Methyl-D-Aspartate receptor encephalitis: a promising approach for refractory cases.
作者信息
Yang Xiaobo
机构信息
Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Neurol Sci. 2025 Mar 25. doi: 10.1007/s10072-025-08134-6.
BACKGROUND
Anti-N-methyl-D-aspartate receptor encephalitis is a severe neurological disorder. While standard treatments work for many patients, up to 25% are resistant to these treatments. In such challenging cases, there is growing interest in using intrathecal approaches.
METHODS
A narrative review of relevant papers was conducted.
RESULTS
Case reports and case series have demonstrated the successful use of intrathecal methotrexate, either alone or in combination with steroids, particularly in pediatric patients. Additionally, intrathecal rituximab has shown promise in select cases.
CONCLUSIONS
Although outcomes vary, this approach appears to be safe and has the potential to rescue refractory cases.
背景
抗N-甲基-D-天冬氨酸受体脑炎是一种严重的神经系统疾病。虽然标准治疗方法对许多患者有效，但高达25%的患者对这些治疗有耐药性。在这种具有挑战性的情况下，人们对使用鞘内注射方法的兴趣日益增加。
方法
对相关论文进行了叙述性综述。
结果
病例报告和病例系列已证明单独或与类固醇联合使用鞘内注射甲氨蝶呤是成功的，特别是在儿科患者中。此外，鞘内注射利妥昔单抗在某些病例中显示出前景。
结论
尽管结果各不相同，但这种方法似乎是安全的，并且有可能挽救难治性病例。
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