Application of N-methyl-aspartate receptor antibody level, brainstem auditory evoked potential and magnetic resonance imaging in the differential diagnosis of encephalitis in children
10.3760/cma.j.issn.1003-9279.2019.02.019
- VernacularTitle: NMDAR抗体水平和脑干听觉诱发电位以及磁共振成像在儿童脑炎鉴别诊断中的应用
- Author:
Xijuan LIU
1
;
Hong QIU
;
Lijun LU
;
Naisheng WU
Author Information
1. NICU of Ningbo Women and Children Hospital Ningbo 315000, China
- Publication Type:Journal Article
- Keywords:
NMDAR antibody;
Brainstem auditory evoked potential;
Magnetic resonance imaging;
Viral encephalitis;
Children
- From:
Chinese Journal of Experimental and Clinical Virology
2019;33(2):202-206
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical value of serum N-methyl-aspartate receptor (NMDAR) antibody level, brainstem auditory evoked potential (BAEP) and magnetic resonance imaging (MRI) in the differential diagnosis of viral encephalitis and anti-NMDAR encephalitis.
Methods:The clinical data of 68 children patients with encephalitis were retrospectively analyzed. The patients diagnosed with viral encephalitis were included in V group (n=52), and the patients diagnosed with anti-NMDAR encephalitis were included in N group (n=16). The clinical characteristics, serum NMDAR antibody level, and BAEP and MRI findings were compared between the two groups.
Results:The age, disease duration, abnormal behavior rate, sleep disorder rate and epileptic seizure rate in V group were significantly lower than those in N group [(6.62±1.20)Y/O vs.(8.46±1.85)Y/O, (3.53±0.71)d vs.(4.49±0.82)d, 30.77%(16/52)vs. 75.00%(12/16), 21.15%(11/52)vs. 62.50%(10/16), 26.92%(14/52)vs. 56.25%(9/16), t=4.681, t=4.560, χ2=9.882, χ2=7.958, χ2=4.701], while the abnormal rate of video EEG was significantly higher than that in N group [51.92(27/52)vs. 81.25%(13/16), χ2=4.345] (all P<0.05). There were no significant differences in gender, rates of prodromic infection symptoms, cognitive impairment, fever, headache, convulsion and incidence rate of meningeal irritation sign (P>0.05). The serum NMDAR antibody level in V group was significantly lower than that in N group [(3.40±0.69) ng/ml vs.(13.95±2.78) ng/ml t=25.319)] (P<0.05). There were no significant differences in the BAEP apparent involvement range and central auditory neurological damage between the two groups (P>0.05), but the peripheral auditory nerve damage and total BAEP abnormality rate in V group were significantly lower than those in N group [3.85%(4/104)vs. 21.88%(7/32), 6.73%(7/104)vs. 28.12%(9/32), 30.77%(16/52)vs. 62.50%(10/16), χ2=10.699, χ2=10.790, χ2=5.216] (all P<0.05). There were no significant differences in MRI signal intensity, lesion involvement range and total abnormal rate between the two groups (all P>0.05).
Conclusions:There were significant differences in serum NMDAR antibody level and BAEP test results among children patients with viral encephalitis or anti-NMDAR encephalitis, and they are helpful for early differential diagnosis.
