摘要
目的总结富亮氨酸胶质瘤失活1蛋白(LGI1)抗体脑炎的临床特点,以提高临床对该病的认识。方法分析2016-01-01—2018-01-31作者医院收治的6例确诊LGI1抗体脑炎患者的临床表现、头颅MRI、脑电图、腰椎穿刺和血生化检查等资料,总结其临床特点。结果 6例LGI1抗体脑炎患者平均年龄(62.8±11.7)岁(48～75岁),男女比为5∶1。6例患者首发症状各异,主要临床表现为面-臂肌张力障碍发作(FBDS)、近记忆力下降、睡眠增多、痫性发作等。4例头颅MRI表现异常,主要累及双侧颞叶、海马。6例血及脑脊液LGI1抗体结果均为阳性,3例出现低钠血症。所有患者行肿瘤筛查均未发现肿瘤。6例经糖皮质激素治疗后预后好,随访均无复发。结论近记忆力减退、FBDS及低钠血症是LGI1抗体脑炎的主要特征性表现,通过脑脊液或血清学抗体检测可明确诊断,如及时治疗预后良好。
Objcetive To summarize the clinical characteristics of leucine-rich glioma-inactivated 1 protein(LGI1)antibody encephalitis to enhance recognition of this disease.Methods The clinical manifestations,brain MRI,electroencephalogram,lumbar puncture and biochemical findings of 6 cases of LGI1 antibody encephalitis were analyzed.Then we summarized the clinical features.Results The average age of the 6 patients with LGI1 antibody encephalitis was(62.8±11.7)years(48-75 years),and the ratio of male to female was 5∶1.All the patients had different initial symptoms.Faciobrachial dystonic seizures(FBDS),memory deficits,sleep disorder and epileptic seizures were the main clinical manifestations.Brain MRI revealed abnormalities in the temporal lobe and the hippocampus in four patiants.The LGI1 antibodies in the blood and/or cerebrospinal fluid(CSF)were positive in all the six patients.Three patients had hyponatremia.No tumor was found in any patient.All the six cases had good prognosis with glucocorticoids treatment.No recurrence was found during follow-up.Conclusions The main clinical manifestations of LGI1 antibody encephalitis are memory deterioration,FBDS and hyponatremia,and LGL1 antibody encephalitis could be diagnosed by cerebrospinal fluid or serological antibody detection.Timely treatments often result in good clinical prognosis.
作者
王起
杨静
才丽娜
王凌霄
王培福
WANG Qi;YANG Jing;CAI Lina;WANG Lingxiao;WANG Peifu(Department of Neurology,Aerospace Central Hospital,Beijing 100049,China)
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2019年第1期44-47,51,共5页
Chinese Journal of Neuroimmunology and Neurology
