抗Ma2抗体相关脑炎临床和影像学分析

Clinical and imaging analysis of anti-Ma2 associated encephalitis

目的探讨抗Ma2抗体相关脑炎的临床表现、实验室检查和神经影像学特点,以期为临床诊治该病提供参考。方法回顾性收集作者医院2015年1月至2017年12月诊断的3例抗Ma2抗体相关脑炎患者的临床资料。结果3例抗Ma2抗体相关脑炎临床表现包括记忆下降、精神行为异常、癫痫发作等,1例患者存在睡眠障碍。3例患者血清抗Ma2抗体均呈阳性,脑脊液中该抗体阳性1例。3例患者均有头颅MRI多发异常信号,主要位于边缘系统和脑干上部。1例患者发现肺癌。结论抗Ma2抗体与边缘性脑炎或脑干脑炎关系密切。对于抗Ma2抗体相关脑炎患者,需要重点排查潜在恶性肿瘤。

Objective To explore the clinical characteristics,laboratory examination and neuroimaging features of anti-Ma2 associated encephalitis,and to assist the diagnosis and treatment.Methods Clinical data of 3 patients with anti-Ma2 associated encephalitis diagnosed in our hospital from January 2015 to December 2017 were retrospectively collected.Results Three patients with positive serum and/or cerebrospinal fluid anti-ma2 antibody were diagnosed as anti-Ma2 associated encephalitis.The clinical manifestations included memory disturbance,mental and behavior disorders,epileptic seizure,etc.One patient had sleep disorders.All the three patients had multiple abnormal signals on cranial MRI.The lesions mainly located in the limbic system and the upper brainstem.Conclusions Anti-Ma2 antibody is a classical anti-intracellular antigen antibody,which is closely related to limbic encephalitis or brainstem encephalopathy.For patients with positive anti-ma2 antibody limbic encephalitis or brainstem encephalopathy,it is important to screen for potential malignant tumors.