儿童抗N-甲基-D-天门冬氨酸受体脑炎12例临床及脑电图特点分析  

The clinical and EEG characteristics of anti-N-methyl-D-aspartate receptor encephalitis in children

作　　者：李华[1] 肖静[1] 吕俊兰[1] 方方[1] 王晓慧[1] 陈春红[1] 丁昌红[1] 伍妘[1] 张炜华[1] 李久伟[1] 韩彤立[1] 王红梅[1] 杨欣英[1] 吴沪生[1] 

机构地区：[1]首都医科大学附属北京儿童医院神经康复中心儿科学国家重点学科,北京100045

出　　处：《中国实用儿科杂志》2014年第2期125-128,共4页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨儿童抗N-甲基-D-天门冬氨酸（NMDA）受体脑炎脑电图特点。方法回顾性分析2011年8月至2013年1月首都医科大学附属北京儿童医院收治的12例抗NMDA受体脑炎患儿临床资料，其中男4例，女8例；就诊年龄平均（9．7±3．3）岁，范围4岁9个月至15岁6个月；就诊时病程中位数13．5d（7d至1．5个月）。对住院期间持续脑电图（CEEG）监测结果进行分析。结果12例住院时间中位数31．5d（范围14～141d）。临床表现：精神行为异常12例、运动障碍11例、惊厥发作6例。12例患儿住院期间进行了平均（5．3±2．1）h的脑电监测，其中广泛性或弥漫性慢波4例、限局性慢波6例、癫痫性放电5例。12例中3例监测到极度δ刷状波（extreme delta brush，EDB）。存在EDB脑电现象的3例住院时间分别为22d、141d、99d。结论EDB现象是抗NMDA受体脑炎脑电图特殊表现，且其存在有一定的临床提示作用。Objective To study the EEG patterns of anti-NMDA receptor encephalitis in children. Methods Retrospectively study the clinical data of 12 cases of anti-NMDA receptor encephalitis in child patients, and analyze the multiple continuous CEEG monitoring results during hospital stay. Results We have studied twelve child patients, 4 male, and 8 female, at the average age of（9.7±3.3 ）years （ranging from 4 years 9 months to 15 years 6 months）, with average course of disease at 13.5 days （7 days to 1.5 month） ,with average hospital stay at 31.5 clays （ 14 days to 141 days）.The clinical features suggested mental and behavior disorder in 12 cases, ataxia in 11 cases and seizure in 6 cases.We monitored CEEG at an average of （5.3±2.1） hours in 12 child patients in hospital, which showed generalized or diffuse slow waves in 4 cases, focal slow waves in 6 cases and epileptic discharge in 5 eases ; 3 cases of child patients had extreme delta brush in EEG.The 3 child patients with extreme delta brush were more serious and with a prolonged hospital stay. Conclusion Extreme delta brush is a special display in EEG patterns of anti-NMDA receptor encecehalitis ; its existence has certain connection with the severity of the state of illness.

关 键 词：儿童 抗N-甲基-D-天门冬氨酸受体 脑炎 脑电图 极度6刷状波 

分 类 号：R72[医药卫生—儿科]