论文部分内容阅读
目的总结神经元表面抗体相关脑炎临床表现、脑电图和头部MRI特点,探讨脑电图对判断疾病复发或波动的意义,以及与MRI病灶相对应的脑电图特点和各临床病程分期的脑电图特点。方法共23例神经元表面抗体相关脑炎患者,根据临床病程分期分为上升期、极期、下降期和恢复期,记录脑电图背景活动、慢波分布范围、样放电和极度δ刷,分析其与疾病复发或波动的关系、与头部MRI表现的一致性,以及各病程分期的脑电图特点。结果 23例患者中19例为抗N-甲基-D-天冬氨酸(NMDA)受体脑炎、3例为抗富亮氨酸胶质瘤失活基因1抗体相关脑炎、1例为抗γ-氨基丁酸B型受体脑炎。临床症状发生率由高至低依次为精神症状或认知功能障碍、癫发作、意识障碍、言语障碍和运动障碍。发病30.50 d内6例脑电图背景活动为慢波,其中2例疾病复发或波动;5例背景活动为α节律,无一例复发或波动。有极度δ刷与无极度δ刷的抗NMDA受体脑炎患者首次住院时间(Z=-0.785,P=0.433)和疾病复发或波动发生率(Fisher确切概率法:P=0.155)差异均无统计学意义。各病程分期脑电图背景活动与头部MRI表现并不完全匹配。上升期和极期脑电图背景活动多为慢波,且慢波分布范围相对较广泛;自下降期开始,背景活动以α节律为主;恢复期慢波分布范围缩小。结论疾病早期脑电图背景活动可能与疾病复发或波动有关。各病程分期脑电图改变与头部MRI表现的不匹配提示应重视神经元表面抗体相关脑炎患者的神经功能检查。不同病程分期脑电图特点不同。
Objective To summarize the clinical manifestations, electroencephalogram and head MRI features of neuron-related surface antibody-associated encephalitis and explore the significance of electroencephalography (EEG) in judging the relapse or fluctuation of the disease and the characteristics of EEG and corresponding clinical stages of MRI lesions EEG features. Methods A total of 23 patients with neuron-related surface antibody-associated encephalitis were divided into three phases: ascending phase, ascending phase, ascending phase, and convalescent phase. The EEG background activity, the distribution of slow waves, Analyze the relationship with the relapse or fluctuation of the disease, the consistency with the head MRI performance, and the characteristics of the electroencephalogram of the stages of the disease. Results Of the 23 patients, 19 were anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, 3 were anti-leucine-rich glioma inactivated 1 antibody-associated encephalitis, and 1 Anti-γ-aminobutyric acid type B receptor encephalitis. The incidence of clinical symptoms from high to low followed by mental symptoms or cognitive dysfunction, epilepsy, disturbance of consciousness, speech impairment and dyskinesia. The incidence of EEG background was slow wave in 6 cases within 30.50 days, of which 2 cases relapsed or fluctuated. The background activity of 5 cases was α rhythm, with no recurrence or fluctuation. The first hospital stay (Z = -0.785, P = 0.433) and the incidence of disease recurrence or fluctuation (Fisher exact test: P = 0.155) in patients with NMDA receptor encephalitis with extreme δ brush and no extreme δ brush were all significantly different Statistical significance. The staging of EEG background activity and head MRI performance does not match exactly. Most of the activities in the ascending and the polar EEG background were slow waves, and the distribution of the slow waves was relatively extensive. From the beginning of the descending period, the activity of the background was dominated by the alpha rhythm; and the range of the slow waves in the recovery period was narrowed. Conclusion Early background EEG background activity may be related to disease recurrence or fluctuation. The mismatch between changes of staging electroencephalogram and head MRI manifestations in each course of disease suggests that neurological function tests should be emphasized in patients with neuron-related surface antibody-associated encephalitis. Different stages of EEG characteristics of different staging.