摘要
目的探讨抗γ-氨基丁酸B受体(GABA BR)抗体脑炎的临床特点、影像学特征及可行的治疗方法。方法回顾性分析2015年5月—2017年2月第三军医大学第一附属医院神经内科住院血清及脑脊液抗GABA BR抗体阳性患者5例的临床表现、脑脊液、脑电图及影像学特点及治疗效果。结果 5例患者均亚急性起病,伴发热2例5例均出现癫痫发作,首发症状抽搐3例、记忆减退2例;脑脊液(CSF)白细胞升高3例,颅内压增高2例,CSF蛋白增高1例,糖、氯化物均在正常范围,5例患者血清及脑脊液抗GABAB BR抗体均为阳性;5例患者均出现不同程度脑电图异常;头部MR显示边缘系统异常信号,其中1例PET-CT扫描提示左侧海马区FDG摄取增高5例均给予激素联合抗癫痫治疗,4例症状好转,1例症状无明显改善。结论抗GABA BR脑炎是以癫痫发作为特点的脑炎,免疫治疗有效。
Objective To discuss the clinic features of newly diagnosed anti-GABA B receptor encephalitis. Methods A retrospective analysis from May 2015 to February 2017, the characteristics and effect of treatment of 5 cases of cerebrospinal fluid and serum anti GABA BR antibody positive patients in the First Affiliated Hospital of Third Military Medical University, clinical manifestations, cerebrospinal fluid, EEG and imaging findings were analyzed. Results Five cases with anti-GABA B receptor antibody presented a subacute onset,2 combined with fever. All attack by epileptic seizure. In three of the five patients, clinical seizures were the initial symptom, two were memory deficit. Long-term EEG showed abnormal. There were hyper-intensive signal in T2/FLAIR in all patient's limbic system. Two patients had additional autoimmune antibody in serum and cerebrospinal fluid(CSF). 1 patient underwent CT/PET CT. Patients received immune regulation therapy got better outcome. Conclusion Anti-GABA B receptor encephalitis with the initial symptoms showed epilepsy can be treated. Immunomodulating therapy may be helpful to those patients.
出处
《疑难病杂志》
CAS
2017年第11期1149-1151,共3页
Chinese Journal of Difficult and Complicated Cases
