目的 总结三类抗代谢性谷氨酸受体(mGluRs)脑炎的临床特征，以期加深对该类脑炎的认识，加强早期诊治并改善临床预后。方法 通过检索PubMed、Web of Science、中国知网、万方数据库，检索截至2023年10月之前发表的所有有关抗mGluRs脑炎的中英文文章，收集并归纳三种抗mGluRs脑炎的临床信息。结果 检索到关于抗mGluRs脑炎文章共49篇，最终纳入抗mGluR1脑炎40例，抗mGluR2脑炎3例，抗mGluR5脑炎43例。抗mGluR1脑炎好发中年女性，主要表现为小脑综合征(95。0%，38/40);22。5%(9/40)的患者发现肿瘤，以淋巴瘤多见(66。7%，6/9);首次头部MRI异常约占52。8%(19/36)，其中约一半患者在随访中发现小脑萎缩。抗mGluR2脑炎主要表现为小脑综合征;肿瘤仅在2例国外患者中发现。抗mGluR5脑炎易累及中青年男性，边缘系统症状是其特征性表现，以精神行为异常与认知障碍最常见(74。4%，32/43);16。3%(7/43)的患者发生肿瘤，均为霍奇金淋巴瘤。结论 对于任何出现急性或亚急性小脑共济失调，伴有MRI小脑异常或萎缩的患者，都应高度怀疑抗mGluR1/2脑炎的可能性，而对于以精神行为异常和认知改变为突出或首发症状的患者，需警惕抗mGluR5脑炎的可能。
Clinical features of anti-metabotropic glutamate receptor encephalitis
Objective To summarize the clinical features of three types of anti-metabotropic glutamate receptors(mGluRs)encephalitis,and to deepen the understanding of such diseases,enhance early diagnosis and treatment,and improve clinical prognosis.Methods PubMed,Web of Science,CNKI,and Wanfang Data were searched for Chinese and English articles on anti-mGluRs encephalitis published up to October 2023,and the clinical data of three subtypes of anti-mGluRs encephalitis were collected and analyzed.Results A total of 49 articles on anti-mGluRs encephalitis were obtained,with 40 cases of anti-mGluR1 encephalitis,3 cases of anti-mGluR2 encephalitis,and 43 cases of anti-mGluR5 encephalitis.Anti-mGluR1 encephalitis was more likely to occur in middle-aged women,with the main manifestation of cerebellar syndrome(95.0%,38/40);among the 40 patients with anti-mGluR1 encephalitis,22.5%(9/40)were found to have tumors,with lymphoma being the most common type of tumor(66.7%,6/9);52.8%(19/36)of the patients were found to have initial head MRI abnormalities,and about half of the patients were found to have cerebellar atrophy during follow-up.Anti-mGluR2 encephalitis had the main clinical manifestation of cerebellar syndrome,and tumor was only ob-served in 2 foreign patients.Anti-mGluR5 encephalitis easily affected young and middle-aged men,with the characteristic manifestation of limbic system symptoms,among which mental and behavioral disorders were the most common symptoms(74.4%,32/43);tumors were observed in 16.3%(7/43)of the patients,all of whom had Hodgkin's lymphoma.Conclusion The possibility of anti-mGluR1/2 encephalitis should be considered for patients with acute or subacute cer-ebellar ataxia accompanied by abnormal MRI cerebellar signals or atrophy,and the possibility of anti-mGluR5 encephalitis should be considered for patients with the initial symptoms of mental and behavioral disorders and cognitive changes.
Metabotropic glutamate receptorsAutoimmune encephalitisAntibodiesCerebellar syn-dromeLimbic system symptoms
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