摘要: 抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎是目前较受关注的自身免疫性脑炎,可伴或不伴卵巢畸胎瘤。临床表现包括显著前驱高热、精神症状、癫痫发作、意识障碍、口手运动障碍及自主神经功能障碍等;脑脊液和血清抗NMDAR 抗体检测呈阳性反应,脑电图呈特异性“δ 刷”表现。早期施行肿瘤切除和免疫抑制剂治疗有效。本文拟就抗NMDAR 脑炎发病机制、临床表现、辅助检查等研究进展进行概述。
关键词:
受体,
N-甲基-D-天冬氨酸,
脑炎,
自身免疫疾病,
综述
Abstract: Anti-N-methyl-D-aspartate (anti-NMDA ) receptor encephalitis is a new category of treatable encephalitis associated with anti-NMDA receptor antibody, which attracts more and more attention recently. It is clinically characterized by prodromal fever, schizophrenia-like psychiatric symptoms, seizures, disturbance of consciousness, dyskinesia (particularly orofacial), and autonomic dysfunction, which often occur in young females with ovarian teratomas. Autoantibodies to the anti-NMDA receptor in serum and cerebrospinal fluid are positive. Electroencephalogram (EEG) often reveals diffuse δ slowing without paroxysmal discharges, on which " δ rush" is considered as specific characteristic in some patients. Combined therapy including tumor resection and immunotherapy is recommended. The updates in mechanisms, clinical manifestations and diagnostic examinations associated with anti-NMDA receptor encephalitis will be discussed in this review.
Key words:
Receptors, N-methyl-D-aspartate,
Encephalitis,
Autoimmune diseases,
Review
陈向军,李翔. 抗N-甲基-D-天冬氨酸受体脑炎:一种新型自身免疫性脑炎[J]. 中国现代神经疾病杂志, 2013, 13(1): 12-15.
CHEN Xiang-jun, LI Xiang. Anti-N-methyl-D-aspartate receptor encephalitis: a new autoimmune encephalitis[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2013, 13(1): 12-15.