抗γ-氨基丁酸B型受体脑炎3例报道并文献复习

发布时间：2018-02-25 01:14

本文关键词： 抗γ-氨基丁酸B型受体边缘性脑炎癫痫　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨抗γ-氨基丁酸B型受体(γ-aminobutyric acid-B receptor,GABABR)脑炎的临床特点及治疗方案。方法:回顾性分析3例抗GABABR脑炎患者的临床资料并结合国内外文献进行综合分析。结果:3例抗GABABR脑炎患者均以亚急性起病,2例以抽搐、1例以头痛、发热为首发症状;3例均有精神行为异常、记忆力下降、抽搐症状;2例颅脑MRI显示边缘系统长T2信号,FLAIR呈高信号,3例脑电图均有不同程度异常;1例发病前有子宫颈癌病史;1例免疫治疗后症状完全缓解,1例抗病毒治疗后症状有所改善。结论:抗GABABR脑炎的主要临床表现为精神行为异常、记忆力下降和癫痫发作,颅脑MRI可见颞叶内侧或海马异常信号影,但临床表现和影像学特点缺乏特异性,且与“病毒性脑炎”相似,临床上易漏诊、误诊,故对疑是患者应尽早完善GABABR抗体筛查。该病对免疫治疗敏感,提高该病的认识和早期诊断、早期治疗尤为重要。
[Abstract]:Objective: To evaluate the efficacy of gamma aminobutyric acid type B receptor (gamma -aminobutyric acid-B receptor, GABABR) the clinical characteristics and treatment of encephalitis. Methods: a retrospective analysis of 3 patients with anti GABABR encephalitis in patients with clinical data were analyzed with literature. Results: 3 cases of anti GABABR encephalitis patients with subacute onset. 2 cases with convulsions, 1 cases with headache, fever as the first symptom; 3 cases had abnormal mental behavior, memory loss, convulsive symptoms; 2 cases of brain MRI showed that the long edge of the T2 signal system, FLAIR showed high signal, 3 cases had different degrees of abnormal EEG; 1 cases had a history of cervical cancer before the disease; 1 cases of immunotherapy after complete remission of symptoms, the symptoms improved after antiviral treatment in 1 cases. Conclusion: the main clinical anti GABABR encephalitis is manifested as mental behavior, memory loss and seizures, brain MRI or medial temporal lobe hippocampus shows abnormal signal, but The clinical manifestation and imaging features are lack of specificity, and "viral encephalitis" similar to clinical misdiagnosis, missed diagnosis, the suspected patients should as soon as possible to improve GABABR antibody screening. The disease is sensitive to immunotherapy, increased awareness and early diagnosis of the disease, early treatment is very important.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.9

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