儿童抗NMDAR脑炎回顾性研究并文献分析

发布时间：2018-04-02 18:14

本文选题：儿童　切入点：抗NMDAR脑炎　出处：《福建医科大学》2015年硕士论文

【摘要】：【目的】探讨儿童抗NMDAR脑炎(Anti-NMDAR encephalitis,ANE)患者的临床特点,提高对该病的认识。【方法】对2012年9月至2015年3月福建省立医院儿科3例临床诊断为抗NMDAR脑炎患者进行回顾性调查及随访研究,探讨其临床特点、治疗及预后相关因素。【结果】3例患者中,男性2例,女性1例(年龄5岁-9岁,平均年龄6岁)。临床表现主要为抽搐(2例),头痛(1例),精神异常(3例),语言障碍(1例),自主神经症状(1例),睡眠障碍(1例),刻板动作(1例)等;MRI提示双侧顶叶脑室三角区白质区斑片状异常信号(1例);脑电图呈弥漫性慢波,其中1例出现锐波样放电;脑脊液白细胞数升高(2例);脑脊液寡克隆蛋白检测阳性(3例);脑脊液抗NMDAR抗体阳性(3例)。其中2例经甲泼尼龙和免疫球蛋白治疗痊愈,1例经抗癫痫治疗后好转。【结论】儿童抗NMDAR脑炎的常见临床表现为精神异常、抽搐、运动障碍、睡眠障碍等,脑脊液和(或)血浆抗NMDAR抗体检测是诊断该病的特异性辅助检查,免疫治疗疗效显著,预后较好。
[Abstract]:[objective] to investigate the clinical characteristics of children with Anti-NMDAR encephalitis ANEA (Anti-NMDAR encephalitis).[methods] from September 2012 to March 2015, 3 pediatric patients diagnosed as anti-encephalitis in Fujian Provincial Hospital were retrospectively investigated and followed up, and their clinical characteristics were discussed.Treatment and prognostic factors. [results] among the 3 patients, 2 were male and 1 was female (age 5-9 years, mean age 6 years).The main clinical manifestations were convulsive syndrome (n = 2), headache (n = 1), mental disorder (n = 3), speech disorder (n = 1), autonomic nervous system (n = 1), sleep disorder (n = 1), white matter area in the trigonometry of parietal ventricle (n = 1).A case of abnormal signal in the pattern of plaque was found in 1 case, and the EEG showed diffuse slow wave, and the electroencephalogram (EEG) showed diffuse slow wave.Among them, 1 case had sharp wave discharge, 2 cases had increased white blood cell count in cerebrospinal fluid, 3 cases had positive oligoclonal protein detection in cerebrospinal fluid, 3 cases had anti NMDAR antibody positive in cerebrospinal fluid.The detection of anti NMDAR antibody in cerebrospinal fluid and / or plasma is a specific adjuvant examination for diagnosis of the disease.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R742.1

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