抗NMDA受体脑炎七例临床分析

Anti-N-methyl-D-aspartic acid receptor encephalitis： clinical analysis of 7 cases

目的 总结抗NMDA受体脑炎的临床及辅助检查的特点、提高对该病的认识.方法 分析2010年1月至2012年12月在宣武医院神经内科就诊的7例抗NMDA受体脑炎患者的临床特征、辅助检查,总结不同治疗方案的预后.结果 7例患者表现为显著的精神症状、癫痫、运动障碍,部分患者伴随自主神经功能异常,MRI显示边缘系统异常信号；CSF及血清NMDA受体抗体阳性,5例患者预后良好.结论 及时的诊断及治疗有助于抗NMDA受体脑炎患者的恢复.

Objective To summarize the clinical manifestations, immunotherapeutic response and prognosis of anti-N-methyl-D-aspartic acid （ NMDA ） receptor encephalitis. Methods We analyzed the clinical features, tumor markers, serum/cerebrospinal fluid （CSF） antibodies of seven cases with anti- NMDA receptor encephalitis. And the prognosis of different treatments was observed. Results Seven patients presented with significant psychiatric symptoms, memory loss, epilepsy, movement disorders and decrease consciousness. And some patients required assisted ventilation because of dysautonomia. All electroencephalographs showed slow wave activity without epileptic form discharges. Magnetic resonance imaging was normal or showed T2W and Flair-phase high signal in limbic system, cortex, thalamus. And CSF and serum anti-NMDA receptor antibodieswere positive （ n = 6 ）. Conclusion Anti-NMDA receptor encephalitis is a kind of fatal but treatable condition. And timely diagnosis and treatment may yield a favorable prognosis.