Anti-N-methyl-D-aspartate receptor encephalitis that aggravates after acinetobacter baumannii pneumonia:A case report

We report an atypical case of anti-N-methyl-D-aspartate receptor encephalitis(ANMDARE). A 27-year-old man diagnosed with ANMDARE received immunotherapy and had a good recovery. However, within one month, he developed severe status epilepticus and decreased level of conscience with new hyperpyrexia and dyspnea, and was admitted to the emergency intensive care unit. Acinetobacter baumanii were found in the sputum culture; and anti-NMDAR antibodies were positive(titer: 1/80) in the cerebrospinal fluid. Repeated immunotherapy was administered with antibacterial agents, and the patient recovered except for mild psychiatric sequelae. This is the first report of ANMDARE that aggravates after acinetobacter baumannii pneumonia. Awareness and knowledge of this disorder should be extended, especially in the emergency medicine community.

Anesthetic Management of Patients with Anti-N-methyl-D-aspartate Receptor Encephalitis:A Report of Two Cases

ANTI-N-METHYL-D-ASPARTATE (NMDA) receptorencephalitis is a newly recognized autoimmunedisease. It is predominantly described in youngwomen with a series of symptoms, includingpersonality change, memory loss, seizures, involuntarymovements, autonomic dysfunction et al.1 It is commonlyassociated with mature ovarian teratomas.2 Since its firstdenomination by Dalmau et al,1 many scientific publicationshave emerged on anti-NMDA receptor encephalitis, butonly a few focused on the anesthetic management ofpatients with this disease.3-5 Herein we reported two caseswith anti-NMDA receptor encephalitis in association withovarian teratoma and discussed the anesthetic managementand the outcomes of these patients.

N-methyl-D-aspartate receptor subunit 1 regulates neurogenesis in the hippocampal dentate gyrus of schizophrenia-like mice

N-methyl-D-aspartate receptor hypofunction is the basis of pathophysiology in schizophrenia. Blocking the N-methyl-D-aspartate receptor impairs learning and memory abilities and induces pathological changes in the brain. Previous studies have paid little attention to the role of the N-methyl-D-aspartate receptor subunit 1 (NR1) in neurogenesis in the hippocampus of schizophrenia. A mouse model of schizophrenia was established by intraperitoneal injection of 0.6 mg/kg MK-801, once a day, for 14 days. In N-methyl-D-aspartate-treated mice, N-methyl-D-aspartate was administered by intracerebroventricular injection in schizophrenia mice on day 15. The number of NR1-, Ki67- or BrdU-immunoreactive cells in the dentate gyrus was measured by immunofluorescence staining. Our data showed the number of NR1-immunoreactive cells increased along with the decreasing numbers of BrdU- and Ki67-immunoreactive cells in the schizophrenia groups compared with the control group. N-methyl-D-aspartate could reverse the above changes. These results indicated that NR1 can regulate neurogenesis in the hippocampal dentate gyrus of schizophrenia mice, supporting NR1 as a promising therapeutic target in the treatment of schizophrenia. This study was approved by the Experimental Animal Ethics Committee of the Ningxia Medical University, China (approval No. 2014-014) on March 6, 2014.

Propofol effectively inhibits lithium-pilocarpine-induced status epilepticus in rats via downregulation of N-methyl-D-aspartate receptor 2B subunit expression

Status epilepticus was induced via intraperitoneal injection of lithium-pilocarpine.The inhibitory effects of propofol on status epilepticus in rats were judged based on observation of behavior,electroencephalography and 24-hour survival rate.Propofol（12.5-100 mg/kg） improved status epilepticus in a dose-dependent manner,and significantly reduced the number of deaths within 24 hours of lithium-pilocarpine injection.Western blot results showed that,24 hours after induction of status epilepticus,the levels of N-methyl-D-aspartate receptor 2A and 2B subunits were significantly increased in rat cerebral cortex and hippocampus.Propofol at 50 mg/kg significantly suppressed the increase in N-methyl-D-aspartate receptor 2B subunit levels,but not the increase in N-methyl-D-aspartate receptor 2A subunit levels.The results suggest that propofol can effectively inhibit status epilepticus induced by lithium-pilocarpine.This effect may be associated with downregulation of N-methyl-D-aspartate receptor 2B subunit expression after seizures.

Influences of levodopa on expression of N-methyl-D-aspartate receptor-1-subunit in the visual cortex of monocular deprivation rats

AIM: Many studies have demonstrated N-methyl-D-aspartate receptor-1-subunit (NMDAR1) is associated with amblyopia. The effectiveness of levodopa in improving the visual function of the children with amblyopia has also been proved. But the mechanism is undefined. Our study was to explore the possible mechanism. METHODS: Sixty 14-day-old healthy SD rats were randomly divided into 4 groups, including normal group, monocular deprivation group, levodopa group and normal saline group, 15 rats each. We sutured all the rats' unilateral eyelids except normal group to establish the monocular deprivation animal model and raise them in normal sunlight till 45-day-old. NMDAR1 was detected in the visual cortex with immunohistochemistry methods, Western Blot and Real time PCR. LD and NS groups were gavaged with levodopa (40mg/kg) and normal saline for 28 days respectively. NMDAR1 was also detected with the methods above. RESULTS: NMDAR1 in the visual cortex of MD group was less than that of normal group. NMDAR1 in the visual cortex of LD group was more than that of NS group. CONCLUSION: NMDAR1 is associated with the plasticity of visual development. Levodopa may influence the expression of NMDAR1 and improve visual function, and its target may lie in the visual cortex.

Gamma-aminobutyric acid A receptor and N-methyl-D-aspartate receptor subunit expression in rat spiral ganglion neurons

BACKGROUND： Gamma-aminobutyric acid A （GABAA） and N-methyl-D-aspartate （NMDA） receptors are significant receptors in the central nervous system. An understanding of GABAA and NMDA receptor expression in spiral ganglion neurons （SGN） provides information for the functional role of these receptors in the auditory system. OBJECTIVE： To investigate mRNA expression of GABAA receptor （GABAAR） and NMDA receptor （NMDAR） subunits in the rat SGN. DESIGN, TIME AND SETTING： This in vitro, molecular biological study was performed at the Laboratory of Otolaryngology-Head and Neck Surgery, Guangxi Medical University, China from July 2007 to May 2008. MATERIALS： Reverse Transcriptase Kit and Taq DNA polymerase were purchased from Fermentas Burlington, ON, Canada; GABAAR and NMDAR primers were purchased from Shanghai Sangon, Shanghai, China. METHODS： SGN from 3-5 day postnatal Wistar rats was collected for primary cultures, mRNA expression of GABAAR and NMDAR subunits in the SGN was determined by reverse transcription polymerase chain reaction. MAIN OUTCOME MEASURES： Expression levels of GABAAR and NMDAR subunits were determined by quantitative analysis. RESULTS： GABAAR subunits （αl 6, β1 3, and y1 3） and NMDAR subunits （NR1, NR2A, NR2B, NR2C, NR2D, NR3A, and NR3B） were detected in the SGN. In α subunit genes of GABAAR, α1 and α3 expression was similar （P 〉 0.05） and greater than the other subunits. Of the β subunit genes, β1 subunit mRNA levels were greater than β2 and β3. Of the y subunit genes, y2 subunit mRNA levels were greater than y1 and y3. NR1 mRNA expression was the greatest of NMDAR subunits. CONCLUSION： GABAAR subunits （α1 6, β1-3, and y1-3） and NMDAR subunits （NR1, NR2A, NR2B, NR2C, NR2D, NR3A, and NR3B） were expressed in the rat SGN. Through comparison of GABAAR and NMDAR subunit expression, possible GABAAR combinations, as well as highly expressed subunit combinations, were estimated, which provided information for pharmacological and electrophysiological characteristics of GABAAR in the auditory system.

Changes in synaptic and extrasynaptic N-methyl-D-aspartate receptor-mediated currents at early-stage epileptogenesis in adult mice

Previous reports have shown that N-methyl-D-aspartate （NMDA） receptors are extensively involved in epilepsy genesis and recurrence. Recent studies have shown that synaptic and extrasynaptic NMDA receptors play different, or even opposing, roles in various signaling pathways, including synaptic plasticity and neuronal death. The present study analyzed changes in synaptic and extrasynaptic NMDA receptor-mediated currents during epilepsy onset. Mouse models of lithium chloride pilocarpLne-induced epilepsy were established, and hippocampal slices were prepared at 24 hours after the onset of status epilepticus. Synaptic and extrasynaptic NMDA receptor-mediated excitatory post-synaptic currents （NMDA-EPSCs） were recorded in CA1 pyramidal neurons by whole-cell patch clamp technique. Results demonstrated no significant difference in rise and delay time of synaptic NMDA-EPSCs compared with normal neurons. Peak amplitude, area-to-peak ratio, and rising time of extrasynaptic NMDA-EPSCs remained unchanged, but decay of extrasynaptic NMDA-EPSCs was faster than that of normal neurons, These results suggest that extrasynaptic NMDA receptors play a role in epileptogenesis.

Kappa opioid receptor antagonist and N-methyl-D-aspartate receptor antagonist affect dynorphin-induced spinal cord electrophysiologic impairment

The latencies of motor- and somatosensory-evoked potentials were prolonged to different degrees, and wave amplitude was obviously decreased, after injection of dynorphin into the rat subarachnoid cavity. The wave amplitude and latencies of motor- and somatosensory-evoked potentials were significantly recovered at 7 and 14 days after combined injection of dynorphin and either the kappa opioid receptor antagonist nor-binaltorphimine or the N-methyl-D-aspartate receptor antagonist MK-801. The wave amplitude and latency were similar in rats after combined injection of dynorphin and nor-binaltorphimine or MK-801. These results suggest that intrathecal injection of dynorphin causes damage to spinal cord function. Prevention of N-methyl-D-aspartate receptor or kappa receptor activation lessened the injury to spinal cord function induced by dynorphin.

Dose-dependent and combined effects of N-methyl-D-aspartate receptor antagonist MK-801 and nitric oxide synthase inhibitor nitro-L-arginine on the survival of retinal ganglion cells in adult hamsters

This study investigated the effects of daily intraperitoneal injections of N-methyl-D-aspartate receptor antagonist MK-801 and nitric oxide synthase inhibitor nitro-L-arginine （L-NA） on the survival of retinal ganglion cells （RGCs） at 1 and 2 weeks after unilateral optic nerve transection in adult hamsters. The left optic nerves of all animals were transected intraorbitally 1 mm from the optic disc and RGCs were retrogradely labeled with Fluorogold before they received different daily dosages of single MK-801 or L-NA as well as daily combinational treatments of these two chemicals. All experimental and control animals survived for 1 or 2 weeks after optic nerve transection. Our results revealed that the mean numbers of surviving RGCs increased and then decreased when the dosage of MK-801 （1.0, 3.0 and 4.5 mg/kg） and L-NA （1.5, 3.0, 4.5 and 6.0 mg/kg） increased at both 1 and 2 weeks survival time points. Daily combinational use of 1.0 mg/kg MK-801 and 1.5 mg/kg L-NA lead to a highest RGC number that was even higher than the sum of the RGC numbers in 1.0 mg/kg MK-801 and 1.5 mg/kg L-NA subgroups at 2 weeks. These findings indicated that both MK-801 and L-NA can protect axotomized RGCs in a dose-dependent manner and combinational treatment of these chemicals possesses a potentiative and protective effect.

N-methyl-D-aspartate receptor subtype 3A promotes apoptosis in developing mouse brain exposed to hyperoxia

In the present study, 7 day postnatal C57/BL6 wild-type mice （hyperoxia group） and 7 day postnatal N-methyI-D-aspartate receptor subtype 3A knockout mice （NR3A KO group） were exposed to 75% oxygen and 15% nitrogen in a closed container for 5 days. Wild-type mice raised in normoxia served as controls. TdT-mediated dUTP nick end labeling （TUNEL）/neuron-specific nuclear protein （NeuN） and 5-bromo-2＇-deoxyuridine （BrdU）/NeuN immunofluorescence staining showed that the number of apoptotic cells and the number of proliferative cells in the dentate subgranular zone significantly increased in the hyperoxia group compared with the control group. However, in the same hyperoxia environment, the number of apoptotic cells and the number of proliferative cells significantly decreased in the NR3A KO group compared with hyperoxia group. TUNEL＋/NeuN＋ and BrdU＋/NeuN~ cells were observed in the NR3A KO and the hyperoxia groups. These results demonstrated that the NR3A gene can promote cell apoptosis and mediate the potential damage in the developing brain induced by exposure to non-physiologically high concentrations of oxygen.

Cognitive disorder and changes in cholinergic receptors, N-methyl-D aspartate receptors, neural cell adhesion molecule, and brain-derived neurotrophic factor following brain injury

BACKGROUND： Learning and memory damage is one of the most permanent and the severest symptoms of traumatic brain injury; it can seriously influence the normal life and work of patients. Some research has demonstrated that cognitive disorder is closely related to nicotine cholinergic receptors, N-methyl-D aspartate receptors, neural cell adhesion molecule, and brain-derived neurotrophic factor. OBJECTIVE： To summarize the cognitive disorder and changes in nicotine cholinergic receptors, N-methyl-D aspartate receptors, neural cell adhesion molecule, and brain-derived neurotrophic factor following brain injury. RETRIEVAL STRATEGY： A computer-based online search was conducted in PUBMED for English language publications containing the key words ＂brain injured, cognitive handicap, acetylcholine, N-methyl-D aspartate receptors, neural cell adhesion molecule, brain-derived neurotrophic factor＂ from January 2000 to December 2007. There were 44 papers in total. Inclusion criteria： ① articles about changes in nicotine cholinergic receptors, N-methyl-D aspartate receptors, neural cell adhesion molecule, and brain-derived neurotrophic factor following brain injury; ② articles in the same researching circle published in authoritative journals or recently published. Exclusion criteria： duplicated articles. LITERATURE EVALUATION： References were mainly derived from research on changes in these four factors following brain injury. The 20 included papers were clinical or basic experimental studies. DATA SYNTHESIS： After craniocerebral injury, changes in these four factors in brain were similar to those during recovery from cognitive disorder, to a certain degree. Some data have indicated that activation of nicotine cholinergic receptors, N-methyl-D aspartate receptors, neural cell adhesion molecule, and brain-derived neurotrophic factor could greatly improve cognitive disorder following brain injury. However, there are still a lot of questions remaining; for example, how do these factors change at different time points after brain injury, and what is the relationship between associated factors and cognitive disorder. CONCLUSION： It is necessary to comprehensively study some associated factors, to analyze their changes and their relationship with cognitive disorder following brain injury, and to investigate their effects at different time points after brain injury.

Effect of Xingnaojing Injection(醒脑静注射液)on Hippocampal N-methyl-D-aspartic Acid Receptors of Focal Cerebral Ischemia in Rats

Objective: To observe and elucidate the neuroprotective effect of Xingnaojing (XNJ) injection on hippocampal N-methyl-D-aspartic acid (NMDA) receptors of focal cerebral ischemia in rats. Methods: Cerebral ischemia was established by occluding the middle cerebral artery with an intraluminal suture technique in rats. Neurological deficit score, infarct volume and quantity of NMDA receptors were estimated in all groups and compared. Results: After being treated with XNJ, the score decreased in the initial 6 hours and infarct volume decreased in 24 hours. And within 24 hours, the quantity of NMDA receptors obviously decreased compared with the model group (P<0. 01) It indicated that XNJ could ameliorate neurological behavior of middle cerebral artery occlusion rats and down-regulate the expression of hippocampal NMDA receptors. Conclusion: The neuroprotective effect of XNJ on focal cerebral ischemia is possibly related to down-regulating the expression of NMDA receptors in rats.

Water-soluble lipopolymer delivery of N-methyl-D-aspartic acid receptor 2B siRNA relieves chronic neuropathic pain in rats

Spinal dorsal horn N-Methyl-D-aspartic acid receptor 2B （NR2B） overexpression plays an important role in the production and maintenance of neuropathic pain. Because small interfering RNA （siRNA） can inhibit NR2B expression, siRNA may provide a novel approach to treat neuropathic pain and possibly nerve injury. However, an efficient and safe vector for NR2B siRNA has not been discovered. This study shows that a water soluble lipopolymer （WSLP） comprised of low molecular weight polyethyleneimine （PEI） and cholesterol can deliver siRNA targeting NR2B for the treatment of neuropathic pain. Results show that intrathecal injection of WSLP/siRNA complexes for 3 days inhibit NR2B gene expression with reductions in mRNA and protein levels by 59% and 54%, respectively, compared with control rats （P 〈 0.01）. Injection of WSLP complexed with scrambled siRNA, or PEI with siRNA did not show this inhibitory effect. Moreover, injection of WSLP/siRNA complexes significantly relieved neuropathic pain at 3, 7, 12, and 21 days, while injection of WSLP with scrambled siRNA or PEI with siRNA did not. These results demonstrate that WSLP can efficiently deliver siRNA targeting NR2B in vivo and relieve neuropathic pain.

继发于单纯疱疹病毒脑炎的抗NMDAR和抗GABA_(BR)双阳性自身免疫性脑炎1例报告及文献复习

目的:分析1例单纯疱疹病毒性脑炎(HSVE)继发抗N-甲基-D-天冬氨酸受体(NMDAR)和抗γ-氨基丁酸B型受体(GABA_(BR))双阳性自身免疫性脑炎(AE)患者的临床表现及诊疗经过,以提高临床医生对该类病的认识。方法:收集1例HSVE继发抗NMDAR和抗GABA_(BR)双阳性AE患者的临床资料,对其诊断和治疗经过进行总结,并结合相关文献进行复习。结果:患者,男性,36岁,以头痛起病,随后出现肢体抽搐,并进展为意识障碍。入院后脑脊液常规生化检测异常,脑脊液单纯疱疹病毒1型(HSV-1) IgG抗体阳性,脑脊液和血清NMDAR抗体检测阳性,头部磁共振成像(MRI)检查提示右侧枕叶白质异常信号,诊断为HSVE继发抗NMDAR脑炎。数月后患者出现精神行为异常、认知障碍和睡眠障碍等症状,血清NMDAR抗体和GABA_(BR)抗体均阳性,诊断为HSVE继发抗NMDAR脑炎和抗GABA_(BR)脑炎。给予激素冲击和静脉注射免疫球蛋白(IVIG)治疗后,患者病情好转出院。随访1年,患者精神症状完全消失,遗留轻度认知功能障碍。结论:HSVE抗病毒治疗有效的恢复期患者临床症状再度恶化时,应高度怀疑继发AE的可能,应尽快完善自身免疫性抗体检测,以期早期诊断,早期治疗,以改善患者预后。

血必净对抗N-甲基-D-天门冬氨酸受体脑炎小鼠海马神经元的保护作用及机制

目的探讨血必净对抗N-甲基-D-天门冬氨酸受体(NMDAR)脑炎小鼠的治疗作用及对辅助性T细胞1(Th1)/辅助性T细胞2(Th2)变化的影响。方法实验分组:对照组、模型组、低剂量血必净组、高剂量血必净组,每组10只小鼠,除对照组外,其余3组小鼠采用抗原注射与免疫刺激建立抗NMDAR脑炎模型,低、高剂量血必净组的小鼠分别通过腹腔注射5 ml/kg、10 ml/kg血必净注射液,12 h注射1次,连续3 d;2周后,HE染色观察小鼠脑组织病理学改变,尼氏染色观察小鼠神经细胞形态变化,TUNEL染色检测小鼠神经细胞凋亡情况,ELISA检测小鼠血清和脑脊液中肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素4(IL-4)、干扰素γ(IFN-γ)含量,免疫组织化学染色与Western blotting检测脑组织IFN-γ、IL-4表达情况,流式细胞术检测外周血Th1、Th2细胞比例分布,并计算Th1/Th2比值。结果与模型组比较,低剂量血必净组和高剂量血必净组的小鼠海马组织损伤得到改善,神经细胞形态变化较小,尼氏小体形态较为完整且数目增加,神经细胞的TUNEL阳性率降低,血清和脑脊液中TNF-α、IL-1β、IFN-γ含量均减少而IL-4含量增加,脑组织内IFN-γ阳性细胞百分比与蛋白相对表达量降低,IL-4阳性细胞百分比与蛋白相对表达量升高,外周血分化簇(CD)4^(+)IFN-γ^(+)标记的Th1细胞比例、Th1/Th2比值降低,且高剂量血必净组小鼠外周血CD4^(+)IL-4^(+)标记的Th2细胞比例升高,差异均具有统计学意义(P<0.05)。与低剂量血必净组比较,高剂量血必净组小鼠的上述各项检测指标改善效果更为明显,且差异也均具有统计学意义(P<0.05)。结论血必净能够改善抗NMDAR脑炎小鼠海马神经元损伤,该作用可能与减少IFN-γ表达、促进IL-4表达进而维持Th1/Th2细胞平衡有关。

抗N-甲基-D-天冬氨酸受体脑炎急性期严重程度及短期预后影响因素分析

目的 探究抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎患者急性期严重程度及短期预后的影响因素。方法 纳入2020年1月至2023年7月四川大学华西医院收治的60例抗NMDAR脑炎患者,根据急性期改良Rankin量表(mRS)评分分为轻症组(mRS≤3分,25例)和重症组(mRS> 3分,35例),根据我院治疗1个月后mRS评分分为短期预后良好组(mRS≤3分,32例)和短期预后不良组(mRS> 3分,28例),采用单因素和多因素Logistic回归分析筛查抗NMDAR脑炎患者急性期病情严重及短期预后不良的危险因素。结果 存在意识障碍(OR=8.975,95%CI:2.048~39.327;P=0.004)及高中性粒细胞百分比/白蛋白比值(NPAR;OR=5.004,95%CI:1.138~22.011,P=0.033)是抗NMDAR脑炎急性期病情严重的危险因素,高血清IgE水平是其急性期病情较轻的保护因素(OR=0.994,95%CI:0.989~0.999;P=0.026);女性(OR=4.380,95%CI:1.205~15.929;P=0.025)、存在意识障碍(OR=5.493,95%CI:1.535~19.657;P=0.009)及高NPAR(OR=2.949,95%CI:1.010~8.612;P=0.048)是抗NMDAR脑炎患者短期预后不良的危险因素。结论 存在意识障碍、低血清IgE水平及高NPAR是抗NMDAR脑炎患者急性期病情严重的危险因素,女性、存在意识障碍及高NPAR是其短期预后不良的危险因素。NPAR是潜在的评估抗NMDAR脑炎患者急性期严重程度及预测其短期预后的生物学指标。

抗NMDAR脑炎中B细胞相关免疫病理机制与治疗进展

抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎是自身免疫性脑炎中最常见的类型之一,其发病机制与B细胞介导的体液免疫反应产生的抗NMDAR抗体有关。抗NMDAR脑炎患者B细胞表面受体互补决定区3存在特异性核酸排列顺序。CXC趋化因子配体13、白细胞介素-6、白细胞介素-17在B细胞迁移和浸润过程中起重要作用。目前,临床已开始使用利妥昔单抗和托珠单抗治疗抗NMDAR脑炎。未来,深入研究抗NMDAR脑炎中B细胞成熟和克隆分化的分子机制,有助于寻找抗NMDAR脑炎的生物标志物,为疾病的早期诊断和靶向治疗提供理论支持。

卵巢畸胎瘤相关抗N-甲基-D-天冬氨酸受体脑炎发病机制及诊疗研究进展

抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎是一种自身免疫性脑炎,是卵巢畸胎瘤的罕见并发症之一,主要治疗方式为手术切除肿瘤联合免疫治疗,但卵巢畸胎瘤相关抗NMDAR脑炎的发病机制目前尚不明确,且患者临床表现多样,多以神经系统表现为主,易误诊及漏诊,需妇科和神经内科医生共同诊断及治疗。本文综述了NMDAR的结构和功能,归纳了既往卵巢畸胎瘤相关抗NMDAR脑炎的相关研究成果,总结其发病机制、早期诊断、鉴别诊断、治疗、预后和复发的研究进展,为更好地诊断和治疗卵巢畸胎瘤相关抗NMDAR脑炎提供理论依据和思路。

抗N-甲基-D-天冬氨酸受体脑炎睡眠障碍研究进展

抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎患者睡眠障碍表现形式多样,易误诊,机制复杂,需早期鉴别诊断与治疗。本文从抗NMDAR脑炎睡眠障碍的临床表现、电生理学特征、发病机制及治疗原则等方面进行综述,以为临床医师识别和治疗抗NMDAR脑炎睡眠障碍提供帮助。

畸胎瘤相关抗N-甲基-D-天冬氨酸受体脑炎1例报告

1病例资料患者女,54岁,汉族,已婚,因“发现腹部包块6年”于2023年1月21日收入海军军医大学(第二军医大学)海军特色医学中心治疗。患者述6年间腹部包块进行性增大,1周前当地医院查腹部超声提示腹腔巨大囊性包块。患者8年前开始出现睡眠障碍,伴情绪低落,不愿意与他人交流,间断性发脾气,易激惹,口舌不自觉发出奇怪声响,在当地中医院进行中药调理,效果不明显。