抗GABA B型受体脑炎临床特征及预后分析

Clinical features and prognosis of anti GABA B recepter encephalitis

目的总结11例抗GABA B型受体(GABABR)脑炎的临床特点、实验室检查、影像学表现、治疗及预后。方法回顾性分析2015年1月至2019年3月在首都医科大学宣武医院神经内科收治的11例抗GABABR脑炎患者临床资料。结果11例患者中男女比例为4∶7,以痫性发作为首发症状10例,2例癫痫持续状态。其他主要表现有认知功能障碍、精神行为异常、睡眠障碍、意识障碍等。4例诊断小细胞肺癌,1例胰腺恶性肿瘤。均接受免疫治疗,8例患者预后良好,1例预后不良,2例复发,2例死于肺癌。结论抗GABABR脑炎患者以新发难治性癫痫和癫痫持续状态为主要表现,易合并肿瘤。多数抗GABABR脑炎患者经免疫治疗预后良好。

Objective To analyze the clinical features,laboratory examinations,imaging,treatment,and prognosis in patients with anti GABA B receptor(GABABR)encephalitis.Methods The clinical data of 11 cases of anti GABABR encephalitis admitted to Xuanwu Hospital Capital Medical University from January 2015 to March 2019 were retrospectively analyzed.Results The male to female ratio of the 11 patients was 4∶7.Seizures were the first symptom in 10 cases,and 2 cases with status epilepticus.Other clinical presentations included cognitive impairments,mental behavioral abnormalities,sleep disorderss,disturbance of consciousness.Four patients had small cell lung cancer,1 case had pancreatic malignant tumor.All of the patients received immunotherapy,8 patients had good prognosis,1 patient had poorprognosis,2 patients had recurrence,2 patients died of lung cancer.Conclusions Anti GABABR encephalitisis is characterized by refractory seizures or status epilepticus,is prone to tumor.Most of the Anti GABABR encephalitisis patients may have good prognosis after immunotherapy.