抗髓鞘少突胶质细胞糖蛋白抗体相关脑炎患者脑电图特点  

The electroencephalogram characteristics of patients with anti-myelin oligodendrocyte glycoprotein-IgG associated encephalitis

作　　者：王瑶 郭静 赵黎明 张佩琪 匡祖颖 李花 WANG Yao;GUO Jing;ZHAO Liming;ZHANG Peiqi;KUANG Zuying;LI Hua(不详;Department of Neurology,Guangdong Sanjiu Brain Hospital,Guangzhou Guangdong 510510,China)

机构地区：[1]广东三九脑科医院神经内科,510510

出　　处：《中国神经免疫学和神经病学杂志》2024年第1期20-24,33,共6页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的探讨抗髓鞘少突胶质细胞糖蛋白(MOG)抗体相关脑炎患者脑电图特点。方法回顾性收集2021年6月至2022年11月广东三九脑科医院收治的MOG抗体相关脑炎患者28例,其中男19例,女9例,年龄(23.0±10.5)岁,病程中位数16 d,四分位数间距39 d。分析患者脑电图特点;根据头颅磁共振病灶分布模式,将患者分为仅皮层和/或脑膜受累组、仅深部白质和/或幕下受累组及混合受累组;根据血清MOG抗体滴度,将患者分为弱阳性组(1∶10)、中等阳性组(1∶32)和强阳性组(1∶100~1∶1000);根据有无复发将患者分为复发组和未复发组,比较各组间脑电图异常率的差异。结果正常脑电图12例(42.9%),异常脑电图16例(57.1%),其中慢波增多11例(39.3%),癫痫样放电8例(28.6%),生理节律消失3例(10.7%)。最常见的异常脑电图为慢波增多,多为局灶性。癫痫样放电多为局灶性,常分布在额区、中央区及前颞区。不同病灶分布模式组间、不同MOG抗体滴度组间以及有无复发组间脑电图异常率比较均无统计学差异(P=0.796,P=0.427,P=0.613)。结论局灶性的慢波增多以及位于额区、中央区或前颞区的局灶性放电提示MOG抗体相关脑炎的可能,脑电图在MOG抗体相关脑炎的诊治中具有重要意义。Objective To explore the electroencephalogram(EEG)characteristics of patients with anti-myelin oligodendrocyte glycoprotein-IgG(MOG-IgG)associated encephalitis.Methods The clinical data of 28 patients with MOG-IgG associated encephalitis hospitalized in Guangdong Sanjiu Brain Hospital from June 2021 to November 2022 were retrospectively analyzed,including 19 males and 9 females with an average age of 23.0±10.5 years,and the median disease course was 16 days,the interquartile range(IQR)was 39 days.We described and analyzed the EEG characteristics of MOG-IgG associated encephalitis.According to different lesion distribution patterns in magnetic resonance images,patients were divided into solely cerebral cortex and/or meninges involved group,solely deep white matter and/or infratentorial structure involved group,and mixed involvement group.According to different titers of serum MOG antibody,patients were divided into mildly positive group(1∶10),moderately positive group(1∶32),and strongly positive group(1∶100-1∶1000).Based on recurrence or not,patients were also divided into recurrence group and non-recurrence group.The EEG abnormal rates between groups were compared.Results Normal EEG was found in 12 cases(42.9%),while abnormality in 16 cases(57.1%).Among them,11 cases(39.3%)showed slow waves,8 cases(28.6%)showed epileptiform discharges,and 3 cases(10.7%)presented with vanishing rhythm.The most common EEG abnormalities in MOG-IgG associated encephalitis were slow waves,the majority of which were focal.Most epileptiform discharges were focal,usually distributed in the frontal region,central region,and anterior temporal region.There were no statistically significant differences in the abnormal rates of EEG among the groups with different lesion distribution patterns,different serum MOG antibody titer or recurrence and non-recurrence group(P=0.796,P=0.427,P=0.613,respectively).Conclusions Focal slow waves and focal discharges located in the frontal region,central region and anterior temporal region indicate t

关 键 词：抗髓鞘少突胶质细胞糖蛋白 抗髓鞘少突胶质细胞糖蛋白免疫球蛋白G抗体相关疾病 MOG抗体相关脑炎 脑电图 

分 类 号：R742[医药卫生—神经病学与精神病学]