| 吴兴饶,孔庆霞,夏敏.伴癫痫发作的自身免疫性脑炎10例诊疗体会[J].济宁医学院学报,2017,40(5):350-354 |
| 伴癫痫发作的自身免疫性脑炎10例诊疗体会 |
| Diagnosis and treatment of 10 cases of autoimmune encephalitis with seizures |
| 投稿时间：2017-07-01 |
| DOI：10.3969/j.issn.1000-9760.2017.05.010 |
| 中文关键词: 自身免疫性脑炎;癫痫发作;抗NMDAR脑炎;LGI1抗体相关脑炎;抗GABABR脑炎 |
| 英文关键词: Autoimmune encephalitis;Seizures;Anti-N-methyl-D-aspartate receptor encephalitis;Leucine-rich gliomainactivated protein 1 antibody encephalitis;Anti-GABAB receptor encephalitis |
| 基金项目:济宁医学院青年基金（JYQ2011KM060）。 |
| 作者 | 单位 | E-mail | | 吴兴饶 | 济宁医学院附属医院, 济宁 272029 | | | 孔庆霞 | 济宁医学院附属医院, 济宁 272029 | kqx1970@aliyun.com | | 夏敏 | 济宁医学院附属医院, 济宁 272029 | |
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| 中文摘要: |
| 目的 总结伴癫痫发作的自身免疫性脑炎（autoimmune encephalitis，AE）临床表现、实验室检验、影像学检查、脑电图特点及其治疗转归，为临床提供参考。方法 回顾性分析我院10例（2014年5月－2017年5月）AE患者的临床资料，结合国内外相关文献报道，总结各型AE患者特点，特别是针对伴有癫痫发作患者的诊疗体会。结果 10例患者平均发病年龄为36岁，临床诊断抗NMDAR脑炎5例，LGI1抗体相关脑炎2例，抗GABABR脑炎1例，2例为已发现颅内肿瘤的AE患者，未行抗体筛查。所有患者（100％）均伴有癫痫发作，其中精神行为异常和认知功能损害分别占30%和50%；4例（40%）出现不自主运动和自主神经功能障碍。8例（80%）患者脑电图存在异常；6例（60%）患者磁共振结果显示异常，与该疾病密切相关的有3例。结论 对于伴有癫痫发作的AE患者，应分析患者发作类型及脑电图特点，结合脑炎的不同类型，合理选用抗癫痫药物，有效控制癫痫发作，提高患者的生存率。 |
| 英文摘要: |
| Objective The clinical manifestations,laboratory tests,imaging studies,EEG characteristics and treatment outcomes were summarized in autoimmune encephalitis with seizures.Methods The clinical data of 10 patients with AE were retrospectively analyzed.Results Among these patients,5 of them were proved to have anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis,while 2 of them got the diagnosis of anti-leucine-rich glioma-inactivated protein 1antibody(LGI1)encephalitis,and the other 1 had anti-γ-aminobutyric acid B receptor(GABABR)antibody encephalitis.2 patients with intracranial tumors were found in patients with autoimmune encephalitis,and they did not carry out antibody screening.All the patients had a seizure,and about 50% of the patients had cognitive and memory dysfunction.About 30% of the patients had psychological symptoms.About 40% of the patients had involuntary movement and autonomic nerve dysfunction.About80% of the patients showed abnormal EEG.About 60% patients had abnormal MRI signal.Conclusion Autoimmune encephalitis patients with seizures should be analyzed for patients with type of attack and EEG characteristics.We should use anti-epilepsy drugs in different types of encephalitis rationally in order to control the seizures and improve the survival rate of patients effectively. |
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