本文選題：抗NMDA受體腦炎 + 腦電圖�。� 參考：《重慶醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:探討15例抗NMDA受體腦炎的臨床特點(diǎn)。方法:回顧性分析我院神經(jīng)內(nèi)科2014年6月至2015年12月確診的15例抗NMDA受體腦炎患者的臨床資料并進(jìn)行隨訪。采用SAS軟件進(jìn)行t檢驗(yàn)和Fisher精確檢驗(yàn)。結(jié)果:本組15例抗NMDA受體腦炎患者年齡17~60歲,女性10例、男性5例,6例有前驅(qū)癥狀。首發(fā)癥狀以精神行為異常者12例、抽搐者2例、不自主運(yùn)動(dòng)者1例。病程中出現(xiàn)精神行為異常者15例,抽搐者13例,不自主運(yùn)動(dòng)者11例,意識(shí)障礙和肌張力障礙者各10例,自主神經(jīng)功能紊亂7例,記憶障礙和低通氣者各6例,言語(yǔ)障礙者4例。所有患者腦脊液中NMDA受體的NR1 IgG抗體陽(yáng)性;腦電圖異常14例,以慢波及慢波活動(dòng)最常見(jiàn),其中2例存在δ刷;腦脊液常規(guī)、生化異常者9例,頭顱MRI異常者5例,3例篩查出可疑腫瘤。9例行靜脈注射免疫球蛋白聯(lián)合激素治療、5例僅行激素治療、1例僅對(duì)癥治療。隨訪3-21月,9例恢復(fù)正�；蚧菊�,2例死亡,3例復(fù)發(fā),1例預(yù)后不詳。結(jié)論:抗NMDA受體腦炎以年輕女性多發(fā),精神行為異常多為首發(fā)癥狀,多數(shù)患者在發(fā)病1月內(nèi)出現(xiàn)3組及以上癥候群。腦脊液常規(guī)、生化、頭顱MRI常無(wú)特異性,腦電圖以慢波及慢波活動(dòng)最常見(jiàn),部分出現(xiàn)δ刷狀波。多數(shù)患者行激素和/或靜脈注射免疫球蛋白治療。60%的患者預(yù)后較好,部分出現(xiàn)復(fù)發(fā),未發(fā)現(xiàn)腫瘤的患者復(fù)發(fā)率較高。
[Abstract]:Objective: to investigate the clinical features of 15 cases of anti-NMDA receptor encephalitis.Methods: the clinical data of 15 patients with anti NMDA receptor encephalitis from June 2014 to December 2015 were retrospectively analyzed and followed up.T test and Fisher accurate test were carried out by SAS software.Results: the age of 15 patients with anti NMDA receptor encephalitis was 1760 years old, 10 female patients and 6 male patients with prodromal symptoms.The first symptom was abnormal mental behavior in 12 cases, convulsion in 2 cases and involuntary exercise in 1 case.There were 15 cases of abnormal mental behavior, 13 cases of convulsion, 11 cases of involuntary movement, 10 cases of consciousness disorder and muscular dystonia, 7 cases of autonomic nervous dysfunction, 6 cases of memory disorder and hypopnea, 4 cases of speech disorder.NR1 IgG antibody of NMDA receptor was positive in cerebrospinal fluid of all patients, EEG abnormality was found in 14 cases, slow wave activity was the most common, among them, 未 brush was found in 2 cases, cerebrospinal fluid routine, biochemical abnormality in 9 cases.5 cases with abnormal cranial MRI and 3 cases with suspicious tumor were screened out. 9 cases were treated with intravenous immunoglobulin combined with hormone therapy. 5 cases were treated only with hormone therapy and 1 case was treated only with symptomatic therapy.9 cases returned to normal or 2 cases died from 3 to 21 months after follow-up. The prognosis of 1 case was unknown.Conclusion: anti NMDA receptor encephalitis is more common in young women, and abnormal mental behavior is the first symptom. Most of the patients have 3 or more syndrome groups within one month after onset of NMDA encephalitis.Cerebrospinal fluid (CSF) was routine, biochemical, and MRI was not specific. Slow wave and slow wave activity were most common in EEG, and 未 brushed wave was found in part of EEG.Most patients were treated with hormone and / or intravenous immunoglobulin. 60% of the patients had better prognosis and some recurrence. The recurrence rate of the patients without tumor was higher.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R742.9

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1 張祥;陳向軍;李翔;葛t熃，

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