抗NMDA受体脑炎的临床分析

Clinical analysis of anti NMDA receptor encephalitis

目的探讨抗N-甲基-D-天冬氨酸（NMDA）受体脑炎患者的临床特征、脑电图、影像学特征及治疗情况，进一步指导临床工作。方法回顾性分析8例抗NMDA受体脑炎患者的临床特征、脑电图、脑脊液及影像学特征和治疗效果。结果7例（87．5％）出现精神症状，6例（75．0％）出现记忆力下降，4例（50．0％）出现癫痈发作，2例（25．0％）出现异动征；6例脑电图异常；8例头颅MRI均有异常；5例脑脊液异常。8例患者应用免疫治疗均取得了明显的疗效。结论抗NMDA受体脑炎是自身免疫反应性脑炎，临床表现缺乏特异性，及时行脑电图、头颅MRI及脑脊液检查有助于早期诊断，早期免疫治疗可获得确切疗效。

Objective To investigate the clinical features EEG, imaging characteristics and treatment of patients with anti-NMDA receptor encephalitis, in order to guide clinical work. Methods Retrospectively analyzed the clinical features, electroencephalogram（EEG） , cerebrospinal fluid, imaging characteristics and therapeutic effect of 8 patients with anti-NMDA receptor encephalitis. Results Seven cases（87.5% ） had mental symptoms, 6 cases（75.0% ） had memory drops, 4 cases（50.0% ） had epileptic seizure, and 2 cases （25.0%） appeared Dyskineia; 6 cases of abnormal Electroencephalogram （EEG） were abnormal; 8 cases of cranial Magnetic resonance imaging（MRI） were abnormal; 5 cases of abnormal cerebrospinal fluid. Immune treatment of 8 cases achieved obvious curative effect. Conclusions Anti-NMDA receptor encephalitis is autoimmune reaction resistance encephalitis and clinical manifestations lack specificity, so timely electroencephalography（ EEG）, cranial magnetic resonance imaging and cerebrospinal fluid examination is helpful to early diagnosis, and early immune treatment can obtain exact curative effect.