本文關(guān)鍵詞：抗GABA_B受體腦炎5例報(bào)道及文獻(xiàn)復(fù)習(xí)　出處：《中風(fēng)與神經(jīng)疾病雜志》2016年05期 　論文類型：期刊論文

  更多相關(guān)文章： 抗GABA_BR腦炎 邊緣性腦炎 癲癇

【摘要】：目的探討抗γ-氨基丁酸受體(GABA_BR)腦炎的臨床特點(diǎn)及診治。方法對(duì)5例抗GABA_BR腦炎患者臨床表現(xiàn)、輔助檢查等進(jìn)行回顧性分析及文獻(xiàn)回顧。結(jié)果 5例抗GABA_B抗體陽(yáng)性患者均亞急性起病,表現(xiàn)為難治性癲癇,其中1例以性格改變、2例以抽搐、2例以記憶減退為首發(fā)癥狀。3例患者頭部MRI顯示邊緣系統(tǒng)異常高信號(hào),3例腦電圖顯示異常,2例腦脊液檢查合并其它自身免疫抗體,2例肺部CT或PET-CT掃描提示肺部占位。經(jīng)給予丙球或激素治療明顯好轉(zhuǎn)。結(jié)論 (1)抗GABA_B受體腦炎首發(fā)癥狀多樣,主要表現(xiàn)為難治性癲癇。(2)對(duì)于懷疑邊緣性腦炎(LE)患者應(yīng)篩查抗GABA_B受體抗體。(3)對(duì)抗GABA_B受體抗體陽(yáng)性的患者應(yīng)該積極進(jìn)行腫瘤的篩查。
[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.
【作者單位】： 首都醫(yī)科大學(xué)宣武醫(yī)院神經(jīng)內(nèi)科;
【分類號(hào)】：R742.9
【正文快照】： 邊緣性腦炎(LE)是一種可累及海馬、杏仁核、島葉及扣帶回皮質(zhì)等邊緣結(jié)構(gòu),亞急性起病,主要表現(xiàn)為近記憶缺損、精神行為異常和癲癇發(fā)作的炎性疾病。該病主要由感染和自身免疫反應(yīng)引起,其中感染主要為病毒通過(guò)血腦屏障進(jìn)入腦內(nèi),主要侵犯以上部位;自身免疫反應(yīng)按免疫病理學(xué)相關(guān)的

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