抗GQ1b抗体阳性的Bickerstaff脑干脑炎的诊断学特征并文献复习  

Diagnostic features and literature review of Bickerstaff brainstem encephalitis with positive anti-GQ1b antibody

作　　者：赵名娟 王展航 徐玉振[3] 叶锦龙 匡祖颖 李丹丹 Zhao Mingjuan;Wang Zhanhang;Xu Yuzhen;Ye Jinlong;Kuang Zuying;Li Dandan(Department of Neurology, Taian Municipal Hospital, Taian 271000, China;Department of Neurology, Guangdong Sanjiu Brain Hospital, Guangzhou 510000, China;Department of Neurology, Taian City Central Hospital, Taian 271000,China)

机构地区：[1]泰安市立医院神经内科,271000 [2]广东三九脑科医院神经内科,广州510000 [3]泰安市中心医院神经内科,271000

出　　处：《中华诊断学电子杂志》2021年第4期255-258,共4页Chinese Journal of Diagnostics(Electronic Edition)

摘　　要：目的探讨抗GQ1b抗体阳性的Bickerstaff脑干脑炎的诊断学特征。方法回顾分析2016年2月至2019年5月经广东三九脑科医院神经内科确诊的3例抗GQ1b抗体阳性的Bickerstaff脑干脑炎患者的临床资料,总结抗GQ1b抗体阳性的Bickerstaff脑干脑炎的诊断学特征,并复习相关文献。结果患者均为女性,年龄分别为16岁、19岁、49岁,发病前均有感染病史。3例均以共济失调起病,2例起病时伴有四肢无力,1例加重后出现意识障碍、四肢无力。3例患者均有眼肌麻痹,2例患者锥体束征阳性。3例患者抗GQ1b抗体均为阳性,头颅磁共振成像平扫及强化扫描未见明显异常,2例患者肌电图诱发电位检查异常,1例患者检查正常。结论Bickerstaff脑干脑炎临床上主要表现为急性眼肌麻痹、共济失调,可伴有意识障碍和(或)锥体束征阳性的综合征,结合血清抗体、影像学及神经电生理检查方能正确诊断。Objective To explore the diagnostic features of Bickerstaff brainstem encephalitis(BBE)with positive anti-GQ1b antibody.MethodsThe clinical data of 3 BBE cases with positive anti-GQ1b antibody diagnosed by the Neurology Department of Guangdong Sanjiu Brain Hospital from February 2016 to May 2019 were retrospectively analyzed.Diagnostic features of BBE with positive anti-GQ1b antibody were summarized,and relevant literatures were reviewed.ResultsThe 3 patients were all female,with the age of 16,19,49 years old respectively,and all of them had a history of infection before the onset.All 3 cases had onset of ataxia,2 cases had limb weakness at the onset,and 1 case developed consciousness disorder and limb weakness after aggravation.On physical examination,3 patients had ophthalmoplegia,and 2 patients had positive pyramidal tract signs.Auxiliary examination:3 patients presented positive of anti-GQ1b antibodies,3 patients showed no obvious abnormalities in brain magnetic resonance imaging(MRI)scan and enhancement,2 patients had abnormal electromyogram evoked potentials,and 1 patient was normal.ConclusionsBBE is a syndrome that mainly manifests as acute ophthalmoplegia,ataxia accompanied by disturbance of consciousness and/or positive pyramidal tract signs.Thorough understanding of associated clinical features and serum antibody,imaging and nerve electrophysiological examination are helpful in achieving at the correct diagnosis.

关 键 词：BICKERSTAFF脑干脑炎 抗GQ1b抗体 MILLER-FISHER综合征 

分 类 号：R74[医药卫生—神经病学与精神病学]