首页|儿童抗 N-甲基-D-天冬氨酸受体脑炎10例分析

儿童抗 N-甲基-D-天冬氨酸受体脑炎10例分析

Clinical analysis of 10 patients with anti -N -methyl -D -aspartate receptor encephalitis

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目的:分析儿童抗 N-甲基-D-天冬氨酸受体(NMDAR)脑炎临床、头颅 MRI 和脑电图(EEG)特点。方法收集10例符合抗 NMDAR 脑炎的患儿临床、头 MRI 和 EEG 资料并进行分析。结果10例抗NMDAR 脑炎患儿中,女7例,男3例,发病年龄1岁1个月至14岁,平均年龄6岁11个月,10例患儿均未伴肿瘤性疾病,伴有癫痫发作者9例,精神行为异常者10例,意识障碍者4例,不自主运动者8例,自主神经功能障碍者5例,睡眠障碍者10例;头颅 MRI 正常者7例,异常者3例,其中为2例为额、颞区异常信号,1例为脑萎缩,与病情不平行;10例患儿 EEG 均异常,多为局灶性或弥漫性慢波活动,5例伴有额、颞区尖慢波,左侧异常高于右侧,与病情相符合。结论抗 NMDAR 脑炎可发生于儿童,女童多于男童,少见合并肿瘤,临床表现主要为精神行为异常、癫痫、不自主运动、意识障碍、睡眠障碍;脑电图监测对于病情及预后判断比头颅 MRI更有意义。
Objective To analyze the clinical feature of the patients with anti -N -methyl -D -aspartate receptor (NMDAR)encephalitis and feature of brain MRI and electroencephalogram (EEG)in children.Methods We reviewed the clinical manifestations,brain MRI and EEG features of 10 patients who were diagnosed anti -NMDAR encephalitis.Results Of the 10 patients,3 cases were male and 7 cases were female.The age was ranged from 13 months to 14 years (6 years and 11 months on average).No tumor was found in those patients.Main symp-toms included seizure in 9 cases,psychiatric symptoms in 10 cases,consciousness disturbance in 4 cases,involuntary movements in 8 cases,autonomic nerve instability in 5 cases,and sleep disorders in 10 cases.7 patients of MRI exami-nation were normal,2 patients revealed abnormal signal of temporal lobe,frontal,and parietal cortex.One patient revealed brain atrophy.All patients had abnormal EEG with diffusive slow waves,and some with focal spikes or sharp waves,left side abnormal more than right side.Conclusion Anti -NMDAR encephalitis can be found in children, even young boys may be affected.They have a lower incidence of tumors.Its predominant clinical features are psychi-atrics symptoms,seizures,involuntary movements and consciousness alteration.EEG was considered more significant than brain MRI.

N -methyl -D -aspartate receptorEncephalitis

杨燕飞、李雅彬、王艳芬

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030032 山西省太原,山西医学科学院儿科

N-甲基-D-天冬氨酸受体 脑炎

2015

中国基层医药
中华医学会,安徽医科大学

中国基层医药

影响因子:1.003
ISSN:1008-6706
年,卷(期):2015.(22)
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