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目的 :探讨抗N-甲基-D-天冬氨酸受体(抗NMDAR)脑炎患儿临床表现及预后。方法:回顾分析本院2013—2015年9例确诊为抗NMDAR脑炎患儿的临床资料。结果:9例均有语言障碍,8例病程中有精神症状,7例出现癫痫样发作,脑脊液及血清抗NMDAR抗体均不同程度阳性;多数患儿预后良好。结论:对于以精神症状或癫痫样发作首发的病例需考虑抗NMDAR脑炎可能,完善抗NMDAR脑炎相关抗体检测可助诊断。早期进行免疫治疗对于逆转抗NMDAR脑炎病情尤为重要,多数患儿经积极免疫治疗后预后良好。
Objective: To investigate the clinical manifestations and prognosis of children with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods: The clinical data of 9 children diagnosed as having anti-NMDAR encephalitis in our hospital from 2013 to 2015 were retrospectively analyzed. Results: All of the 9 patients had speech disorder. Eight patients had mental symptoms during the course of their illness. Seven patients had epileptic seizures. Cerebrospinal fluid and serum anti-NMDAR antibodies were all positive to different degrees. Most children had good prognosis. CONCLUSIONS: It is possible to consider anti-NMDAR encephalitis in cases starting with psychiatric symptoms or epileptic seizures and to improve the detection of anti-NMDAR encephalitis-related antibodies may aid diagnosis. Early immunotherapy for the reversal of anti-NMDAR encephalitis is particularly important, most children with good prognosis after active immunotherapy.