Clinical analysis in patients with anti-N-methyl-D-aspartate receptor encephalitis
10.3760/cma.j.issn.1006-7876.2012.05.005
- VernacularTitle:抗N-甲基-D-天冬氨酸受体脑炎患者临床特点分析
- Author:
Xiang LI
;
Xiangjun CHEN
- Publication Type:Journal Article
- Keywords:
Receptors,N-methyl-D-aspartate;
Antibodies;
Encephalitis;
Autoimmune diseases
- From:
Chinese Journal of Neurology
2012;45(5):307-311
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and the significance of anti-NMDAR antibody assay in clinical diagnosis.Methods Sixty-two patients were divided into 3 groups of encephalitis,encephalopathy and other central nervous system diseases based on their affliction. Anti-NMDAR antibody was detected by transfected cell-based indirect immunofluorescence assay in the serum and cerebrospinal fluid. The clinical features,laboratory tests,treatment and prognosis of NMDAR encephalitis were analyzed.ResultsAnti-NMDAR antibody was positive in serum and (or) cerebrospinal fluid of 9 patients (9/32,28％ ) from encephalitis group.The positive rate of anti-NMDAR antibody in cerebrospinal fluid was higher than that in serum of these patients.Among them,5 patients with higher antibody titer had impaired blood-brain barrier.No tumor was detected in these 9 patients.The most predominant symptoms of anti-NMDAR encephalitis include fever,psychiatric disturbances,seizures,dystonia and autonomic dysfunction.Brain MRI and electroencephalography were also abnormal. Patients were responsive to early immunotherapy. Conclusion Detection of the anti-NMDAR antibody may be important for early diagnosis and treatment of autoimmune encephalitis.
