抗N-甲基-D-天冬氨酸受体脑炎1例报告  

The Clinical Characteristics of Anti-N-methyl-D-aspartate-receptor Encephalitis: One Case Report

作　　者：刘文钰[1] 田林郁[1] 郭佳南 陈佳妮[1] 周东[1] 

机构地区：[1]四川大学华西医院神经内科,610041

出　　处：《中国临床神经科学》2015年第2期147-150,共4页Chinese Journal of Clinical Neurosciences

摘　　要：目的提高临床医生对抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎的认识。方法收集1例18岁女性抗NMDAR脑炎患者的临床资料,对抗NMDAR脑炎的治疗及肿瘤搜索结合文献进行探讨。结果患者因头痛发热9 d,言语行为异常5 d入院,入院后频繁癫发作。肿瘤标记物、免疫、TORCH检查和影像学肿瘤搜索2次检查结果均为阴性,但抗NMDAR抗体阳性,诊断抗NMDAR脑炎、癫持续状态。经呼吸机辅助呼吸、抗癫药和免疫治疗后症状好转。病程约5个月后发现卵巢肿瘤,接受腹腔镜肿瘤切除,病理检查提示畸胎瘤。术后患者高级神经功能迅速恢复。结论抗NMDAR脑炎严重影响患者生活质量,尤其对于年轻女性应积极进行肿瘤搜索,切除肿瘤后患者恢复更快。Aim To help the physician understand anti-N-methyl-D-aspartate-receptor encephalitis （anti-NMDA encephalitis）. Methods With the description of one young female patient with anti-NMDA encephalitis, the treatment especially tumor search of anti-NMDA encephalitis combined with the literatures were discussed. Results A 18 year-old young girl had positive reaction to NMDAR antibody but tumor detection was negative twice. Then she received the first and second line immunotherapy, ventilator breathing and antiepileptic drugs with somehow improvement. About 5 months later, a teratoma was found near her cyst. Then she accepted laparoscopic resection. Pathologic analysis conifrmed teratoma. Advanced nerval function recovered quickly after the operation. Conclusion Anti-NMDA encephalitis may impact on the quality of life of the patients, especially for young women. Efforts for tumor search should always be encouraged.

关 键 词：抗N-甲基-D-天冬氨酸受体脑炎 肿瘤 治疗 

分 类 号：R512.3[医药卫生—内科学]