抗N-甲基-D-天冬氨酸受体脑炎一例  

Anti-N-methyl-D-aspartate receptor encephalitis： an adolescent with ovarian teratoma

作　　者：许春伶[1] 赵伟秦[1] 李继梅[1] 王佳伟[1] 王淑辉[1] 王得新[1] 刘美云[1] 乔衫衫[1] 靳家玉[2] 郝增平[2] 冀晓俊[3] 

机构地区：[1]首都医科大学附属北京友谊医院神经内科,100050 [2]首都医科大学附属北京友谊医院妇产科,100050 [3]首都医科大学附属北京友谊医院中心ICU,100050

出　　处：《中华神经科杂志》2010年第11期781-783,共3页Chinese Journal of Neurology

摘　　要：目的 探讨抗N-甲基-M-天冬氨酸（NMDA）受体脑炎的临床特点、诊断及治疗.方法报道1例伴卵巢畸胎瘤的抗NMDA受体脑炎患者的临床表现及诊治过程,并总结其临床特征.结果患者为青年女性,表现为精神行为异常及抽搐,意识障碍及通气不足.早期发现畸胎瘤,脑脊液中抗NMDA受体抗体阳性.行畸胎瘤手术切除,联合静脉用免疫球蛋白和激素冲击治疗,患者临床痊愈.结论 抗NMDA受体脑炎是一种自身免疫性的、能用血清学方法诊断的疾病.早期明确诊断和给予及时治疗,预后良好.Objective To investigate the clinical presentation,diagnosis,and surgical management of anti-N-methyl-D-aspartate （NMDA） receptor encephalitis.Methods One case of anti-NMDA receptor encephalitis in a previously healthy 17-year-old female related to the development of NMDA receptor autoantibodies triggered by an ovarian teratoma was reported.The related literature was reviewed and the clinical feature was summarized.Results Removal of the ovarian teratoma combined with intravenous immuneglobulin and corticosteroid proved curative with eventual resolution of the paraneoplastic disease process and associated psychiatric symptoms.Conclusion Increasingly,reports of anti-NMDA receptor encephalitis associated with ovarian teratomas,as well as a novel assay to measure these antibodies suggest an etiology for this disease process that may be amenable to prompt surgical excision.

关 键 词：受体 N-甲基-D-天冬氨酸 边缘叶脑炎 畸胎瘤 

分 类 号：R686[医药卫生—骨科学]