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目的：研究抗 N-甲基-D-天冬氨酸（NMDA）受体脑炎患者的临床特点及其不同阶段的脑电图（EEG）表现，提高对这种自身免疫性疾病的认识。方法对3例经血清及脑脊液抗NMDA受体抗体检测呈阳性的患者，对其病史、认知功能、脑脊液、头颅影像学、脑电图、妇科彩超、治疗方案等资料进行详细分析，诊断为抗 NMDA 受体脑炎，并随访2～3年。结果3例患者均为女性，发病年龄分别为22岁、27岁和30岁，以精神异常和癫痫发作为首发症状，病程中表现出意识障碍、运动障碍、语言障碍和认知障碍。脑脊液、头颅 MRI 检查表现无特异改变，EEG 显示呈刷状样波形，2例妇科彩超显示卵巢畸胎瘤，1例由于病情发展迅速，未行超声检查已死亡。病程为1～3个月。结论抗 NMDA 受体脑炎临床表现易与病毒性脑炎混淆，对于无精神病史的患者出现不明原因的精神症状伴痫性发作、记忆丧失、意识水平降低、运动障碍甚至出现中枢性通气不足，特别是伴有卵巢畸胎瘤者的年轻女性，在 EEG 检查中显示呈刷状样波形，应尽早进行抗 NMDA 受体抗体检测，及时诊断和治疗有助于抗 NMDA 受体脑炎患者的恢复。“,”Objective To discuss the clinical features of pantients with anti-N-methyl-D-aspar-tate receptor(NMDAR)encephalitis and the performance of electroencephalogram (EEG)in different phase and make a better understanding in this autoimmune disease.Methods 3 patients were diagnosed NMDAR encephalitis which were confirmed by antibody detection in serum or CSF.We recorded their clinical data,including disease history,CSF data,cranial MR images (MRI),EEG,mini-mental state examination,gynecological ultrasound and treatmentand followed up 2-3 years.Results 3 female patients with onset at age of 22,27 and 30 years old showed common manifestation of psychiatric symptoms and seizures as the initial signs.In course of the disease,some symptoms came out,such as consciousness changes,abnormal movement,speech disturbance and cognitive impairment.Brain MRI was often unremarkable,and CSF reveals nonspecific change.EEG showed brush-δwave.We found teratoma in 2 patients.The third one dead before examination and we could not get autopsy.Conclusion It is difficult to distinguish anti-NMDAR encephalitis from viral encephalitis because they share similar neurological symptoms.However,the anti-NMDAR encephalitis is often associated with the ovarian teratoma and diffuse brush-like delta slowing in EEG.When the typical change of EEG is detected in the patients presenting with seizure,cognitive impairment and consciousness changes,especially in young women with ovarian teratoma,anti-NMDAR antibody detection is necessary for the diagnosis of anti-NMDAR encephalitis.The prognosis of these patients may be improved by early treatment.