抗GABA_B受体脑炎5例报道及文献复习

发布时间：2017-12-26 21:28

本文关键词：抗GABA_B受体脑炎5例报道及文献复习　出处：《中风与神经疾病杂志》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨抗γ-氨基丁酸受体(GABA_BR)脑炎的临床特点及诊治。方法对5例抗GABA_BR脑炎患者临床表现、辅助检查等进行回顾性分析及文献回顾。结果 5例抗GABA_B抗体阳性患者均亚急性起病,表现为难治性癫痫,其中1例以性格改变、2例以抽搐、2例以记忆减退为首发症状。3例患者头部MRI显示边缘系统异常高信号,3例脑电图显示异常,2例脑脊液检查合并其它自身免疫抗体,2例肺部CT或PET-CT扫描提示肺部占位。经给予丙球或激素治疗明显好转。结论 (1)抗GABA_B受体脑炎首发症状多样,主要表现为难治性癫痫。(2)对于怀疑边缘性脑炎(LE)患者应筛查抗GABA_B受体抗体。(3)对抗GABA_B受体抗体阳性的患者应该积极进行肿瘤的筛查。
[Abstract]:Objective to investigate the clinical characteristics and diagnosis and treatment of anti gamma aminobutyric acid receptor (GABA_BR) encephalitis. Methods the clinical and auxiliary examination of 5 patients with anti GABA_BR encephalitis were reviewed and reviewed. Results 5 cases of anti GABA_B antibody positive patients were subacute onset, manifested as intractable epilepsy, including 1 cases of personality change, 2 cases of convulsion, and 2 cases of memory impairment as the first symptom. In 3 patients, the head MRI showed abnormal high signal in the limbic system, 3 cases showed abnormal EEG, 2 cases had cerebrospinal fluid examination combined with other autoantibodies, and 2 cases of lung CT or PET-CT scan showed lung occupying. The treatment was obviously improved by the treatment of prop or hormone. Conclusion (1) the initial symptoms of anti GABA_B receptor encephalitis are diverse, and the main manifestations are refractory epilepsy. (2) anti GABA_B receptor antibodies should be screened for patients suspected of borderline encephalitis (LE). (3) cancer screening should be carried out actively in patients with positive GABA_B receptor antibody.
【作者单位】：首都医科大学宣武医院神经内科;
【分类号】：R742.9
【正文快照】： 边缘性脑炎(LE)是一种可累及海马、杏仁核、岛叶及扣带回皮质等边缘结构,亚急性起病,主要表现为近记忆缺损、精神行为异常和癫痫发作的炎性疾病。该病主要由感染和自身免疫反应引起,其中感染主要为病毒通过血脑屏障进入脑内,主要侵犯以上部位;自身免疫反应按免疫病理学相关的

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