急诊7例自身免疫性脑炎病例分析并文献复习

Autoimmune encephalitis associated with anti-neuronal antibodies:case analysis in emergengcy department and literature review

自身免疫性脑炎(autoimmune encephalitis,AE)是一组以癫痫发作、精神行为异常和认知功能减退为特点的疾病,泛指一大类由自身免疫反应引起的中枢神经系统炎性疾病[1]。自身免疫性脑炎不是脑炎的罕见原因,英国和美国通过多中心前瞻性研究发现,在脑炎中该病的发病率分别为21%与41%[2-3]。

To explore the characteristics of clinical presentation,diagnosis,treatment and outcome of autoimmue encephalitis(AE)according to the latest international clinical guideline.The clinical data of 7 patients with AE were retrospectively analyzed.The mean age at oneset was 33.14±5.47.Among these patients,4 of them were definited to have anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis,while 2 of them probably got autoimmune encephalitis,the other 1 was possible to have autoimmune encephlitis.All the patients presented cognitive and memory dysfunction and psychological sysmptoms.4 of them had a seizure and involuntary movement.3 of them showed abnormal EEG and MRI signal,but none had abnormal CT signal.5 of them were accepted immunotherapy in 10 days from oneset and had a good prognosis,a short period of hospitalization.Testing for autoimmune disease related antibodies in blood and cerebrospinal fluid is necessary in order to avoid misdiagnosis.The earlier the patients diagnosised AE were accepted immunotherapy according to the latest clinical guideline,the better the outcome of these patients.