抗谷氨酸脱羧酶抗体相关脑炎九例临床特点分析  

Clinical characteristics of 9 cases with anti-glutamic acid decarboxylase antibody-associated encephalitis

作　　者：林鑫 陈鑫鑫 张文琳[1] 刘若雪 韩晓晨 赵辉[1] 何俊瑛[1] 卜晖[1] Lin Xin;Chen Xinxin;Zhang Wenlin;Liu Ruoxue;Han Xiaochen;Zhao Hui;He Junying;Bu Hui(Department of Neurology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院神经内科,石家庄050000

出　　处：《中华医学杂志》2021年第33期2625-2628,共4页National Medical Journal of China

摘　　要：本研究总结2018年4月至2020年10月就诊于河北医科大学第二医院神经内科的9例抗谷氨脱羧酶(GAD)抗体相关脑炎患者的临床特点。在9例患者中,7例以癫痫为首发症状,2例以记忆力减退为首发症状。4例患者合并其他自身免疫性疾病。4例患者头MRI显示颞叶内侧结构的异常信号。6例患者的脑电图出现异常放电。8例患者经一线治疗后症状均较前缓解。抗GAD抗体相关脑炎以癫痫为主要临床表现,头颅MRI及脑电图检查对其诊断有指导意义。其中部分患者可合并自身免疫性疾病,因此对于可能患有此类疾病患者,必须进行自身免疫性抗体的检查。一旦确诊抗GAD抗体相关脑炎,应立即启动免疫治疗。This study summarized the clinical characteristics of 9 patients with anti-glutamic acid decarboxylase(GAD)antibody-associated encephalitis in the Department of Neurology of the Second Hospital of Hebei Medical University from April 2018 to October 2020.Among the 9 patients,7 cases had epilepsy as the first symptom and 2 cases had memory loss as the first symptom.Four patients were complicated with other autoimmune diseases.The MRI of 4 patients showed abnormal signals of the medial temporal lobe structures.Abnormal EEG discharges were found in 6 patients.The symptoms of 8 patients were relieved after first-line treatment.The main clinical manifestation of anti-GAD antibody-associated encephalitis was epilepsy,and cranial MRI and EEG had clinical significance in guiding its diagnosis.Some of these patients can have autoimmune diseases simultaneously.Therefore,autoimmune antibodies must be tested for those who may have such diseases.Once anti-GAD antibody-associated encephalitis is diagnosed,immunotherapy should be initiated immediately.

关 键 词：脑炎 自身免疫性脑炎 抗谷氨脱羧酶抗体相关脑炎 癫痫 

分 类 号：R742.9[医药卫生—神经病学与精神病学]