以癫痫发作起病的MOG抗体病1例报告及文献复习

Clinical analysis of myelin oligodendrocyte glycoprotein idiopathic inflammatory demyelinating disease with epilepsy onset:a case report and literature review

目的提高对以癫痫发作起病的髓鞘少突胶质细胞糖蛋白(M0G)抗体介导的特发性炎性脱髓鞘疾病(简称为M0G抗体病)的认识,防止误诊、漏诊。方法回顾性分析徐州医科大学附属医院神经内科2018年7月收治的1例以癫痫发作起病的MOG抗体病患者的临床资料,随访患者病情转归。结果该患者血液学指标MOG抗体阳性,颅脑MRI增强示右侧额顶叶多发异常强化灶,头颅MRI三维液体衰减反转序列(3D-FLAIR序列)示右侧额顶叶多发异常强化灶。予以激素冲击、改善循环、营养神经等综合治疗后症状好转。结论MOG抗体病可能引起癫痫发作,考虑系累及大脑皮质所致,神经内科医生需要高度警惕此病,防止漏诊。

Objective To analyze the clinical data of a case of myelin oligodendrocyte glycoprotein idiopathic inflammatory demyelinating disease (MOG - HDDs) with epilepsy onset,so as to enhance the understanding of the disease and to prevent misdiagnosis. Methods The clinical data of a case of MOG antibody disease with epilepsy onset who were admitted into the Department of Neurology, the Affiliated Hospital of Xuzhou Medical University in July 2018 were retrospectively analyzed. The patient received follow-up visits to evaluate the prognosis. Results MOG antibody was positive in this patient, multiple abnormal enhancement foci in the right frontal and parietal lobes were shown on enhanced cranial MRI, and multiple abnormal enhancement foci in the right frontal and parietal lobes were shown on three-dimensional fluid attenuation inversion sequence (3D-FLAIR sequence). The symptoms of the patient improved after glucocortieoid pulse therapy, improvement of circulation, nerve nutrition and other comprehensive treatments, considering the involvement of cerebral cortex caused by MOG antibody disease. Conclusions MOG-HDDs may cause epilepsy. Neurologists need to be on the alert to prevent misdiagnosis.