抗GAD65抗体脑炎的临床特点

Clinical Characteristics of Anti-GAD65 Antibody Encephalitis

目的回顾性分析7例抗GAD65抗体脑炎患者的临床特点.方法回顾7例GAD65抗体脑炎患者,总结其临床表现和脑电图、实验室检查、影像学检查结果.结果中位年龄44岁,7例患者中仅表现为癫痫4例;表现为头晕,合并有垂直眼震者1例;癫痫合并有僵人综合征1例;表现为精神行为异常症状.脑电图异常者5例,5例表现为局灶性尖波.头MRI显示颞叶异常信号(海马硬化2例)3例.结论抗GAD65抗体脑炎是可治性疾病,表现为癫痫、精神行为异常、记忆力减退,认知障碍,共济失调、脑干受累症状、僵人综合征,临床表现多样性,早期诊断,免疫治疗提高患者预后.

Objective To analyze the clinical features, image character and prognosis of 7 cases of glutamate decarboxylase 65(GAD65) encephalitis. Methods seven encephalitis patients with anti-GAD65 antibodies were selected, the clinical manifestations, electroencephalogram, laboratory examination and imaging findings were summarized. Results Median age was 44. The major clinical features were as follows, four patients with seizures only;one with dizzy and vertical nystagnus;one with seizures and stiff man syndrome;one with memory deficit, mental disturbance. The abnormal electroencephalogram was found in six cases, mainly manifested as focal spike wave. MRI Scan of brain showed abnormal signals in three cases, mainly involved medial temporal lobe, hippoeampus. Conclusion Anti-GAD65 encephalitis is a treatable disease, cardinal clinical features include seizures, cognitive disorders, hypomnesis. Cognitive disorder, ataxia, brainstem symptom, stiff man syndrome, the symptoms are multiple, identify early and immunological will be helpful for patients.