抗NMDA受体脑炎1例报道并文献复习

目的探讨抗NMDA受体脑炎的发病机制、临床表现、辅助检查、及治疗方法。方法报道本院确诊的1例患者的临床资料并复习国内外相关文献。结果本例患者以发热为首发症状,后出现癫癎、精神行为异常、意识障碍、口-面-舌部的异常运动,经脑脊液和血液检测出抗NMDAR抗体,确诊为抗NMDA受体脑炎,经激素及丙种球蛋白治疗后患者基本恢复正常。结论抗NMDA受体脑炎是一种少见的新型自身免疫性脑炎,好发于青年女性,主要表现为癫癎、精神症状、意识障碍、口-面-舌的异常运动等,脑脊液抗NMDAR抗体检测阳性可确诊本病,激素、丙种球蛋白、血浆置换为该病的一线治疗,早诊断、早治疗后大多患者预后良好。

One case of anti-N-methyl-D-aspartate receptor encephalitis was reported and literature were reviewed

Objective To explore the pathogenesy,clinical presentations,auxiliary examination and treatment of Anti-N-methyl-D-aspartate receptor encephalitis.Methods The clinical data of one Anti-N-methyl-D-aspartate receptor encephalitis patient was analyzed respectively and the combining relevant documents were retrospectively analyzed.Results The patient suffered fever,epilepsy,disturbance of mind and behavior,disturbance of consciousness and dyskinesia.It was diagnosed by autoantibodies to the anti-NMDA receptor in serum and cerebrospinal fluid.The patient＇s condition was controlled by corticosteroid hormone and gamma globulin.Conclusions Anti-N-methyl-D-aspartate receptor encephalitis is a new autoimmune encephalitis and involves young female.It is clinically characterized by epilepsy,disturbance of consciousness and dyskinesia.It could be diagnosed by autoantibody to the anti-NMDA receptor in cerebrospinal fluid.Corticosteroid hormone,gamma globulin and plasmapheresis are key therapies.The majority are eusemia by early diagnosis and therapy.