抗N-甲基-D-天冬氨酸受体脑炎12例临床和EEG分析  

Clinical and EEG analysis of 12 cases of anti-N-methyl-D-aspartic acid receptor encephalitis

作　　者：马美刚[1] 吴原[1] 陈志颖[1] MA Mei-gang;WU Yuan;CHEN Zhi-ying(Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China)

机构地区：[1]广西医科大学第一附属医院神经内科,南宁530021

出　　处：《临床神经病学杂志》2018年第2期137-139,共3页Journal of Clinical Neurology

基　　金：广西医科大学青年科学基金项目(GXMUYSF201512)

摘　　要：目的探讨抗N-甲基-D-天冬氨酸(NMDA)受体脑炎的临床特点和EEG动态变化规律。方法对12例抗NMDA受体脑炎患者的临床资料进行回顾性分析。结果本研究共纳入12例确诊的抗NMDA受体脑炎患者,其中男6例,女6例;年龄14~43岁;住院时间为13~84 d。临床表现为精神症状12例,不自主运动12例,昏迷6例,抽搐11例(其中4例出现癫痫持续状态),6例需要辅助呼吸并入住神经内科重症监护病房,8例合并有肺部炎症。入院时EEG:高度异常7例,中度异常4例,轻度异常1例,7例出现δ刷状波,11例出现弥漫性慢波,4例慢波波幅明显不对称,6例出现痫样放电。出院时EEG:高度异常3例,中度异常7例,轻度异常1例,正常EEG 1例,4例出现δ刷状波,7例出现弥漫性慢波,4例慢波波幅明显不对称,1例出现痫样放电。结论 EEG对抗NMDA受体脑炎的诊断具有重要的意义,"δ刷"是其较特异的EEG表现。Objective To explore the dynamic changes of EEG and the clinical characteristics of anti-N-methyl- D-aspartic acid （NMDA） receptor encephalitis. Method The clinical data of 12 patients with anti-NMDA receptor encephalitis were analyzed retrospectively. Results The study included 12 cases of diagnosed patients, 6 males and 6 females ,aging from 14 to 43 years old, with hospital stay 13 - 84 d. The clinical features suggested mental and behavior disorder in 12 cases,involuntary movement in 12 cases, coma in 6 cases, seizure in 11 cases （include status epilepticus in 4 cases） , assisted respiration and stayed in neurology intensive care unit in 6 cases, lung infection in 8 cases. The EEG on admission showed height abnormal in 7 cases, moderately abnormal in 4 cases, mild abnormal in 1 case, δ brush in 7 cases, generalized slow waves in 11 cases, asymmetric in 4 cases and epileptic discharge in 6 cases. The EEG at discharge showed height abnormal in 3 cases, moderately abnormal in 7 cases, mild abnormal in 1 case, δ brush in 4 cases, generalized slow waves in 7 cases, asymmetric in 4 cases and epileptic discharge in 1 cases. Conclusion The EEG plays an important role in the diagnosis of anti-NMDA receptor encephalitis, and the δ brush may be is a special display.

关 键 词：抗N-甲基-D-天冬氨酸受体 脑炎 EEG 

分 类 号：R593.2[医药卫生—内科学]