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Limbic Encephalitis Associated with Anti-y-aminobutyric Acid B Receptor Antibodies: A Case Series from China 被引量:40
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作者 Hong-Zhi Guan Hai-Tao Ren +7 位作者 Xun-Zhe Yang Qiang Lu Bin Peng Yi-Cheng Zhu Xiao-Qiu Shao Yong-Qiang Hu Dong Zhou Li-Ying Cui 《Chinese Medical Journal》 SCIE CAS CSCD 2015年第22期3023-3028,共6页
Background: Autoimmune encephalitis associated with antibodies against γ-aminobutyric acid B receptor (GABABR) in patients with limbic encephalitis (LE) was first described in 2010. We present a series of klan C... Background: Autoimmune encephalitis associated with antibodies against γ-aminobutyric acid B receptor (GABABR) in patients with limbic encephalitis (LE) was first described in 2010. We present a series of klan Chinese patients tbr further clinical refinement. Methods: Serum and cerebrospinal fluid (CSF) samples from patients referred to the program of encephalitis and paraneoplastic syndrome of Peking Union Medical College Hospital were tested with indirect immunofluorescence. Clinical information of patients with anti-GABABR antibody positivity was retrospectively reviewed, and descriptive statistical analysis was performed. Results: All eighteen anti-GABABR antibody-positive cases had limbic syndromes, and electroencephalogram (EEG) or neuroimaging evidence fulfilled the diagnostic criteria of LE. Four patients had additional antibodies against Hu in serum and one had anti-N-methyl-d-aspartate receptor antibody in both sera and CSF. Seventeen (17/18) patients presented with new-onset refractory seizure or status epileptics. Twelve (12/18) patients had memory deficits, 11 (11/18) patients had personality change, 7 (7/18) patients had disturbance of consciousness, and 3 (3/18) patients showed cerebellar dysfunction. One patient with LE had progressive motor and sensory polyneuropathy. Lung cancer was detected in 6 (6/18) patients. Ten (10/18) patients showed abnormality in bilateral or unilateral mediotemporal region on magnetic resonance imaging. Ten (10/18) patients had temporal lobe epileptic activity with or without general slowing on EEG. Seventeen patients received immunotherapy and 15 of them showed neurological improvement. Four patients with lung cancer died within 1-12 months due to neoplastic complications. Conclusions: Our study demonstrates that most Han Chinese patients with anti-GABABR antibody-associated LE have prominent refractory epilepsy and show neurological improvement on immunotherapy. Patients with underlying lung tumor have a relati 展开更多
关键词 anti-γ-aminobutyric acid b receptor antibody Autoimmune: Limbic Encephalitis SEIZURE
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继发于单纯疱疹病毒脑炎的抗NMDAR和抗GABA_(BR)双阳性自身免疫性脑炎1例报告及文献复习
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作者 赵仲艳 徐志育 +3 位作者 吴婵姬 赵二义 黄丹 黄仕雄 《吉林大学学报(医学版)》 CAS CSCD 北大核心 2024年第1期236-242,共7页
目的:分析1例单纯疱疹病毒性脑炎(HSVE)继发抗N-甲基-D-天冬氨酸受体(NMDAR)和抗γ-氨基丁酸B型受体(GABA_(BR))双阳性自身免疫性脑炎(AE)患者的临床表现及诊疗经过,以提高临床医生对该类病的认识。方法:收集1例HSVE继发抗NMDAR和抗GABA... 目的:分析1例单纯疱疹病毒性脑炎(HSVE)继发抗N-甲基-D-天冬氨酸受体(NMDAR)和抗γ-氨基丁酸B型受体(GABA_(BR))双阳性自身免疫性脑炎(AE)患者的临床表现及诊疗经过,以提高临床医生对该类病的认识。方法:收集1例HSVE继发抗NMDAR和抗GABA_(BR)双阳性AE患者的临床资料,对其诊断和治疗经过进行总结,并结合相关文献进行复习。结果:患者,男性,36岁,以头痛起病,随后出现肢体抽搐,并进展为意识障碍。入院后脑脊液常规生化检测异常,脑脊液单纯疱疹病毒1型(HSV-1) IgG抗体阳性,脑脊液和血清NMDAR抗体检测阳性,头部磁共振成像(MRI)检查提示右侧枕叶白质异常信号,诊断为HSVE继发抗NMDAR脑炎。数月后患者出现精神行为异常、认知障碍和睡眠障碍等症状,血清NMDAR抗体和GABA_(BR)抗体均阳性,诊断为HSVE继发抗NMDAR脑炎和抗GABA_(BR)脑炎。给予激素冲击和静脉注射免疫球蛋白(IVIG)治疗后,患者病情好转出院。随访1年,患者精神症状完全消失,遗留轻度认知功能障碍。结论:HSVE抗病毒治疗有效的恢复期患者临床症状再度恶化时,应高度怀疑继发AE的可能,应尽快完善自身免疫性抗体检测,以期早期诊断,早期治疗,以改善患者预后。 展开更多
关键词 单纯疱疹病毒性脑炎 抗N-甲基-D-门冬氨酸受体抗体 γ-氨基丁酸b型受体抗体 自身免疫性脑炎
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以癫痫发作起病的抗GABAB受体脑炎六例 被引量:5
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作者 徐秦岚 崔韬 +2 位作者 史伟雄 王群 李志梅 《脑与神经疾病杂志》 2018年第7期405-410,共6页
目的总结抗r氨基丁酸B型(GABAB)受体脑炎的临床特征以利于早期诊断及治疗。方法对6例抗GABAB受体脑炎患者的临床、实验室、脑电图(EEG)及影像学资料进行分析,并对其进行10~19(13.5±3.1)个月的随访。结果该组患者均以癫痫发作起病,... 目的总结抗r氨基丁酸B型(GABAB)受体脑炎的临床特征以利于早期诊断及治疗。方法对6例抗GABAB受体脑炎患者的临床、实验室、脑电图(EEG)及影像学资料进行分析,并对其进行10~19(13.5±3.1)个月的随访。结果该组患者均以癫痫发作起病,表现为部分性发作、全面强直阵挛发作。5例出现认知功能减退,4例出现精神行为异常。发作间期EEG 1例表现为右前中颞区棘慢波,余未见明显异常。头颅MRI示2例颞叶内侧、海马T2/FLAIR高信号,1例海马体积缩小。腰穿检查2例脑脊液(CSF)压力增高,1例白细胞数增多,4例蛋白升高。所有患者血清及CSF GABAB受体抗体阳性,1例患者血清Hu抗体弱阳性。胸CT示2例肺部占位、2例肺叶微结节、1例纵隔稍大淋巴结及肝脏顶部异常强化灶,4例经活检诊断为小细胞肺癌。抗癫痫药物对患者癫痫发作控制不佳,免疫治疗及抗肿瘤治疗有效。结论抗GABAB受体脑炎可以癫痫发作为首发症状,逐渐出现认知障碍和精神症状,需注意对该类患者进行肿瘤筛查及随访,早期免疫治疗及抗肿瘤治疗可以改善患者神经功能预后。 展开更多
关键词 抗r氨基丁酸b型受体抗体 脑炎 认知功能障碍 精神异常 小细胞肺癌
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