抗NMDA受体脑炎的临床特点分析

Analysis of the clinical characteristics of anti-NMDA receptor in patients with encephalitis

目的探讨抗N-甲基-D-天冬氨酸(NMDA)受体脑炎的临床表现、磁共振(MRI)图像、脑脊液特点及治疗转归。方法回顾性分析2016年3月-2016年12月在新疆医科大学第一附属医院神经内科确诊的6例抗NMDA受体脑炎患者的临床特点。结果 6例患者平均发病年龄为(18.6±12.2)岁,所有患者均有认知功能障碍和精神症状;4例出现癫痫发作;1例出现不自主运动。4例患者脑电图存在异常;2例患者有磁共振检查异常信号。结论以认知功能障碍、精神行为异常、癫痫发作为主要表现的患者,要警惕抗NMDA受体脑炎的可能,以免误漏。

Objective To discuss and analyze the clinical features,MRI image,cerebrospinal fluid characteristics and treatment outcome of patients with anti-N-methyl-D-aspartate（anti-NMDA）receptor encephalitis.Methods Retrospective analysis was performed on six cases of anti-NMDA receptor encephalitis whose clinical data were retrieved in the Department of Neurology of The First Affiliated Hospital of Xinjiang Medical University from March 2016 to December 2016.Results The average age of these six cases was（18.6±12.2）years old.All patients complained of cognitive impairment and psychiatric symptoms.Seizures occurred in four cases.A case presented with involuntary movement and autonomic dysfunction.Four patients presented with abnormal EEG.Two patients had abnormal magnetic resonance imaging.Conclusion Patients with cognitive impairment,mental and behavioral disorders,epilepsy as the main manifestation,keep alert the possibility that anti-NMDA receptor encephalitis so as to the missed diagnosis.