AMPA与NMDA抗体重叠的自身免疫性脑炎合并眼阵挛-肌阵挛综合征1例报告

A case report of anti-NMDAR and anti-AMPAR autoimmune encephalitis with opsoclonus-myoclonus syndrome

眼阵挛-肌阵挛综合征(OMS)是一种少见的神经系统综合征,与肿瘤相关,常见于儿童,成人少见,其特征是不自主、无节律、混乱、多向的眼球不自主运动,通常伴有四肢和躯干肌阵挛性抽搐、共济失调。抗α-氨基-3-羟基-5-甲基-4-异唑丙酸受体(AMPAR)与抗N-甲基-D-天冬氨酸受体(NMDAR)抗体重叠的自身免疫性脑炎合并眼阵挛-肌阵挛综合征的病例报道更为少见,对其临床表现及治疗缺乏全面的认识。现报道1例AMPAR与NMDAR抗体重叠的自身免疫性脑炎合并眼阵挛-肌阵挛综合征患者,并基于此病例对国内外相关文献进行复习,以期提高临床医生的认识。

Opsoclonus-myoclonus syndrome(OMS)is a rare neurological syndrome associated with tumors,which is more common in children than in adults.It is characterized by involuntary,arrhythmic,chaotic,multidirectional saccades,usually accompanied by limb and trunk myoclonic seizures and ataxia.Case reports are even rare on OMS complicated by autoimmune encephalitis with overlapping antibodies against the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor(AMPAR)and N-methyl-D-aspartate receptor(NMDAR),and its clinical manifestations and treatment are poorly understood.We report a case of autoimmune encephalitis with OMS positive for both NMDAR and AMPAR antibodies,and also review relevant literature to help improve the understanding of the condition.