摘要： 目的 总结抗髓鞘少突胶质细胞糖蛋白（MOG）抗体相关皮质脑炎的临床特征。方法 与结果 回顾2021年1月至2025年1月天津市环湖医院收治的8例抗MOG抗体相关皮质脑炎患者的诊断与治疗过程，男女比例1∶1，平均年龄（32.13 ± 13.21）岁；首发症状以头痛、发热和癫痫发作为主；血清抗MOG抗体均呈阳性，6例脑脊液压力升高、6例脑脊液白细胞计数增加，均未发现明确的肿瘤证据；头部MRI表现为单侧（5例）或双侧（3例）大脑皮质弥漫性FLAIR高信号，病变累及额叶（6例）、颞叶（6例）、顶叶（7例）、枕叶（2例）；均经糖皮质激素或联合静脉注射免疫球蛋白治疗后好转，3例复发，再次经糖皮质激素或联合静脉注射免疫球蛋白治疗后好转，未再复发。结论 抗MOG抗体相关皮质脑炎临床表现无特异性，头部MRI表现为单侧或双侧大脑皮质弥漫性异常信号，易误诊为病毒性脑炎；激素联合免疫治疗有效，仍有部分患者复发但症状较轻微。对于抗感染治疗效果欠佳的皮质脑炎患者，应警惕抗MOG抗体相关皮质脑炎，早期诊断，及时予以激素联合免疫治疗。

关键词: 髓鞘少突胶质细胞糖蛋白, 自身抗体, 脑炎, 大脑皮质, 糖皮质激素类, 免疫疗法

Abstract: Objective To explore clinical characteristics of myelin oligodendrocyte glycoprotein (MOG) antibody-associated cortical encephalitis. Methods and Results Retrospective analysis was conducted on clinical data of 8 patients diagnosed with MOG antibody-associated cortical encephalitis in Tianjin Huanhu Hospital from January 2021 to January 2025. The male-to-female ratio was 1∶1, with a mean age of (32.13 ± 13.21) years old. The initial symptoms were primarily headache, fever and epileptic seizures. All patients tested positive for serum anti-MOG antibodies. Cerebrospinal fluid (CSF) analysis showed elevated pressure in 6 cases, and an increased white blood cell count in 6 cases. No definitive evidence of neoplasms was identified in all patient. MRI showed unilateral (5 cases) or bilateral (3 cases) diffuse cortical FLAIR hyperintensity in 8 patients. The lesions involved the frontal lobes in 6 cases, temporal lobes in 6 cases, parietal lobes in 7 cases, and occipital lobes in 2 cases. All patients improved after treatment with glucocorticoid or intravenous immunoglobulin (IVIg). During follow-up, the relapse occurred in 3 patients, who subsequently recovered well after retreatment with glucocorticoid or IVIg, and experienced no further recurrence. Conclusions The clinical manifestations of MOG antibody-associated cortical encephalitis are non-specific. Head MRI shows unilateral or bilateral cortical abnormal signals, which are often misdiagnosed as viral encephalitis. Glucocorticoid is effective in combination with immunotherapy. Although some patients may experience recurrence, the symptoms of recurrence are mild. For patients with cortical encephalitis who have poor response to anti-infection treatment, it is necessary to be vigilant about MOG antibody-associated cortical encephalitis, identify it early and provide combination hormone and immunotherapy in a timely manner.

Key words: Myelin-oligodendrocyte glycoprotein, Autoantibodies, Encephalitis, Cerebral cortex, Glucocorticoids, Immunotherapy