自身免疫性脑炎与睡眠障碍

Autoimmune encephalitis and sleep disorders

自身免疫性脑炎与睡眠障碍关系密切。抗Ma2抗体介导的神经系统副肿瘤综合征可以导致发作性睡病和快速眼动睡眠期行为障碍。边缘性脑炎和Morvan综合征可以导致严重失眠及其他睡眠障碍,常伴抗电压门控性钾离子通道抗体(包括抗富亮氨酸胶质瘤失活基因1抗体和抗接触蛋白相关蛋白-2抗体)阳性。中枢性低通气常见于抗N-甲基-D-天冬氨酸受体脑炎患者。阻塞性睡眠呼吸暂停、喘鸣和异态睡眠是抗IgLON家族蛋白5抗体相关脑病的常见表现。由此可见,睡眠障碍是自身免疫性脑炎的重要表现,免疫治疗有可能改善临床症状和预后。

Research shows that autoimmune encephalitis is associated with sleep disorders.Paraneoplastic neurological syndrome （PNS） with Ma2 antibodies can cause sleep disorders,particularly narcolepsy and rapid eye movement sleep behavior disorder （RBD）.Limbic encephalitis （LE） and Morvan syndrome,associated with voltage-gated potassium channel （VGKC）-complex antibodies,which include leucine-rich glioma-inactivated 1 （LGI1） antibody and contactin-associated protein 2 （Caspr2）,can result in profound insomnia and other sleep disorders.Central neurogenic hypoventilation are found in patients with anti-N-methyl-D-aspartate （NMDA） receptor encephalitis,whereas obstructive sleep apnea （OSA）,stridor and parasomnia are prominent features of encephalopathy associated with IgLON5 antibodies.Sleep disorders are cardinal manifestations in patients with autoimmune encephalitis.Immunotherapy possiblely can improve clinical symptoms and prognosis in a positive way.