10例以精神障碍为首发症状的自身免疫性脑炎临床特点分析  

Analysis on clinical features in 10 cases of autoimmune encephalitis with mental disorder as the initial symptom

作　　者：朱艳青 邵恒 钟静玫[1] 武绍远[1] 陈辉[1] 吴喆 ZHU Yanqing;SHAO Heng;ZHONG Jingmei;WU Shaoyuan;CHEN Hui;WU Zhe(Clinical Psychology,the First People’s Hospital of Yunnan Province,the Affiliated Hospital of Kunming University of Science and Technology,Yunnan,Kunming 650032,China;Department of Geriatric Medicine,the First People’s Hospital of Yunnan Province,the Affiliated Hospital of Kunming University of Science and Technology,Yunnan,Kunming 650032,China)

机构地区：[1]云南省第一人民医院,昆明理工大学附属医院临床心理科,云南昆明650032 [2]云南省第一人民医院,昆明理工大学附属医院老年医学科,云南昆明650032

出　　处：《中国医药科学》2022年第10期197-200,共4页China Medicine And Pharmacy

摘　　要：回顾性分析昆明理工大学附属云南省第一人民医院2015年12月至2019年5月以精神障碍为首发症状的自身免疫性脑炎(AE)患者10例的临床资料,总结各例AE患者的临床特点。10例AE患者为急性或亚急性起病,临床诊断抗N-甲基-D天冬氨酸受体(NMDAR)脑炎8例,抗富含亮氨酸胶质瘤失活蛋白1(LGI1)抗体相关脑炎2例,1例为已发现盆腔肿瘤的AE患者。所有患者均以精神障碍为首发症状,随着病情进展,7例出现癫痫发作,6例出现认知功能下降,2例出现不自主运动,大部分患者头颅MRI、脑电图及腰椎穿刺结果存在异常。10例患者均给予糖皮质激素联合丙种球蛋白治疗,8例AE患者预后较好。The clinical data of 10 cases of autoimmune encephalitis(AE)with mental disorder as the initial symptom in the First People’s Hospital of Yunnan Province,the Affiliated hospital from December 2015 to May 2019 were enrolled and retrospectively analyzed,and clinical features of each AE patient were summarized.10 AE patients had acute or subacute onset,among which 8 cases were clinically diagnosed with anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis,2 cases were diagnosed with anti-leucine-rich glioma-inactivated 1 antibodyassociated(LGI1)encephalitis,and 1 case was an AE patient accompanied with pelvic tumor.The mental disorder was considered the first symptom of all patients.As the disease progressed,epileptic seizure was found in 7 patients,a decline of cognitive function was found in 6 patients,and involuntary movement was observed in 2 patients.Most patients had abnormal results in head MRI,EEG and lumbar puncture results.All these ten patients were treated with glucocorticoid combined with gamma globulin,and eight patients with AE had good prognosis.

关 键 词：自身免疫性脑炎 抗NMDAR脑炎 抗LGI1脑炎 抗GABA_(B)R脑炎 

分 类 号：R742.9[医药卫生—神经病学与精神病学]