以双侧尾状核病变为表现的髓鞘少突胶质细胞糖蛋白抗体相关性脑炎的临床及影像学特点(附1例报告)  

Clinical and imaging features of myelin oligodendrocyte glycoprotein antibody associated encephalitis characterized by bilateral caudate nucleus lesions(report of one case)

作　　者：丁俭 金菁 练学淦[1] 张超[2] 杨松[1] DING Jian;JIN Jing;LIAN Xuegan(Department of Neurology,the Third Affiliated Hospital of Soochow University(the First People's Hospital of Changzhou),Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院(常州市第一人民医院)神经内科,常州213003 [2]天津医科大学总医院神经内科

出　　处：《临床神经病学杂志》2025年第2期87-91,共5页Journal of Clinical Neurology

摘　　要：目的探究抗髓鞘少突胶质细胞糖蛋白(MOG)抗体相关性脑炎的临床及影像学特点。方法报道1例以双侧尾状核病变为影像表现的MOG抗体相关性脑炎。总结临床资料,进行诊断、鉴别诊断和治疗分析,并进行相关文献复习。结果患者为31岁男性,急性起病,主要表现为头痛、发热,CSF细胞及蛋白均增高,血清MOG抗体IgG阳性(1∶100),CSF MOG抗体IgG阳性(1∶10),头颅MRI示双侧尾状核头异常信号。予糖皮质激素冲击治疗后患者头痛快速缓解,体温恢复正常。但后期复查CSF蛋白、血清MOG抗体滴度均较前升高,给予托珠单抗治疗。结论MOG抗体相关性脑炎的临床及影像学表现多种多样,本病例对于丰富其临床特点、影像学谱系及探索治疗方面具有一定的启示意义。Objective To investigate the clinical and imaging features of myelin oligodendrocyte glycoprotein(MOG)antibody associated encephalitis.Methods A case of MOG antibody associated encephalitis with bilateral caudate nucleus lesions as imaging manifestations was reported.Clinical data were summarised,diagnostic,differential diagnosis and therapeutic analyses were performed,and a review of relevant literature was conducted.Results The patient was a 31-year-old male with acute onset of illness,mainly presenting with headache,fever,increased CSF cells and proteins,serum anti-MOG antibody IgG positivity(1∶100),CSF anti-MOG antibody IgG positivity(1∶10),and abnormal signals of bilateral caudate nucleus head on cranial MRI.After hormonal shock treatment,the headache was relieved rapidly and the body temperature returned to normal.However,the CSF protein and serum MOG antibody titre were higher than before,and tolizumab was given.Conclusion MOG antibody-associated encephalitis has a variety of clinical and imaging manifestations,and this case is instructive for enriching its clinical features,imaging spectrum and exploring its treatment.

关 键 词：髓鞘少突胶质细胞糖蛋白抗体相关性脑炎 影像学特点 预后 

分 类 号：R744.5[医药卫生—神经病学与精神病学]