69例儿童抗N-甲基-D-天冬氨酸受体脑炎临床、影像学、脑电图分析  

The clinical,imaging,and electroencephalogram analysis of anti-NMDA receptor encephalitis in 69 children

作　　者：廖红梅[1] 江志[1] 杨赛[1] 旷小军[1] 杨理明[1] 陈波[1] 刘舒蕾 张晓[1] LIAO Hongmei;JIANG Zhi;YANG Sai;KUANG Xiaojun;YANG Liming;CHEN Bo;LIU Shulei;ZHANG Xiao(Department of Neurology,Hunan Children’s Hospital,Changsha 410007,Hunan,China)

机构地区：[1]湖南省儿童医院神经内科,湖南长沙410007

出　　处：《临床儿科杂志》2020年第3期166-169,共4页Journal of Clinical Pediatrics

基　　金：湖南省卫生健康委员会科研计划项目(No.C2019018)。

摘　　要：目的分析儿童抗N-甲基-D-天冬氨酸(抗NMDA)受体脑炎临床表现、影像学及脑电图特点.方法回顾分析2015年6月-2019年3月住院并明确诊断抗NMDA受体脑炎的69例患儿的临床资料.结果69例患儿中,男性39例、女性30例,年龄6个月~13岁6个月.首发症状以抽搐、癫痫样发作最常见(50例,72.5%).所有患儿脑脊液抗-NMDA受体抗体均阳性,3例重叠MOG抗体阳性.66例行头部MRI检查患儿中,最常受损部位为颞叶(37例).67例行脑电图检查患儿中54例异常,最常见的改变为广泛性慢波(20例),枕区节律相对保留,放电以局灶性为主,额、颞、枕区放电多见,与临床发作相符.结论儿童抗NMDA受体脑炎首发症状以抽搐癫痫样发作为主,约50%头部MRI异常,脑电图异常更多见.Objective To explore the clinical manifestations,imaging,and electroencephalogram(EEG)characteristics of anti-NMDA receptor encephalitis in children.Method The clinical data of 69 children who were hospitalized from June 2015 to March 2019 and diagnosed with anti-NMDA receptor encephalitis were retrospectively analyzed.Results In 69 children(39 boys and 30 girls)aged 6 months to 13.5 years,convulsions and epileptic seizures were the most common symptoms(50 cases,72.5%).The anti-NMDA receptor antibodies in cerebrospinal fluid were all positive,and 3 cases were positive for overlapping MOG antibodies at the same time.Among 66 children who had head MRI,the most frequently damaged area was the temporal lobe(37 cases).Among the 67 children who had EEG,54 were abnormal.The most common change was extensive slow wave(20 cases,29.9%),and the rhythm of occipital region was relatively preserved.The discharge was mainly localized,and the discharge in frontal,temporal and occipital areas was common,which was consistent with clinical attack.Conclusions The initial symptom of anti-NMDA receptor encephalitis in children is mainly convulsive epilepsy.About 50%of them have abnormal MRI and EEG abnormalities are more common.

关 键 词：抗N-甲基-D-天冬氨酸受体脑炎 临床症状 脑电图 影像学 儿童 

分 类 号：R742.9[医药卫生—神经病学与精神病学]