以Hunt综合征起病的MOG-IgG相关脑干脑炎1例报告

A case of MOG-IgG-associated brainstem encephalitis originating from hunt syndrome

目的提高临床医生对MOG-IgG相关孤立性脑干脑炎的认识。方法收集并回顾性分析1例以Hunt综合征起病的MOG-IgG相关脑干脑炎患者的临床资料,并进行相关文献检索,归纳总结并讨论。结果患者女性,24岁,主因头晕、左眼睑闭合不全20余天入院,入院后频繁顽固性恶心、呕吐,完善头部MR、腰椎穿刺、神经电图等检查,发现血清MOG-IgG阳性,诊断为MOG-IgG相关脑干脑炎,给予甲泼尼龙冲击治疗,患者症状明显缓解,未再复发。结论MOG-IgG相关孤立性脑干脑炎在临床上较为少见,其临床表现多样,本例患者病灶较为局限、症状较轻,容易漏诊、误诊,通过本例可提高临床医生对此病的认识,为及时治疗及良好预后提供理论依据。

Objective To improve clinicians'understanding of myelin oligodendrocyte glycoprotein-immunoglobulin G(MOG-IgG)-associated isolated brainstem encephalitis.Methods The clinical data of one case of MOG-IgG-associated brainstem encephalitis with Hunt syndrome were collected and retrospectively analyzed,and the relevant literature was searched,summarized,and discussed.Results The patient was a 24-year-old female who was admitted to the hospital mainly for more than 20 days of dizziness and incomplete left eyelid closure.After admission,she frequently suffered from intractable nausea and vomiting.After completing the examinations of head magnetic resonance,lumbar puncture,and electroneurography,and finding of positive serum MOG-IgG,she was diagnosed as having MOG-IgG-associated brainstem encephalitis.She was given methylprednisolone pulse therapy.The patient's symptoms were significantly relieved and did not recur.Conclusion MOGIgG-associated isolated brainstem encephalitis is relatively rare in clinic,and its clinical manifestations are diverse.In this case,the lesion is relatively limited,and the symptoms are mild.Missed diagnosis and misdiagnosis easily occur.This case can improve clinicians'understanding of this disease,and provide a theoretical basis for timely treatment and good prognosis.