Clinical analysis of 20 children with anti-NMDA receptor encephalitis
10.3760/cma.j.issn.1008-6706.2020.22.006
- VernacularTitle:儿童抗N-甲基-D-天冬氨酸受体脑炎20例临床分析
- Author:
Ruijuan SONG
1
Author Information
1. 长治医学院附属和济医院儿科 046000
- From:
Chinese Journal of Primary Medicine and Pharmacy
2020;27(22):2713-2716
- CountryChina
- Language:Chinese
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Abstract:
Objective:To investigate the clinical characteristics, treatment methods, prognosis and relapse of anti-N-methyl-D-aspartate receptor(NMDAR) encephalitis in children.Methods:The clinical data of 20 children with NMDAR encephalitis treated in Heji Hospital Affiliated to Changzhi Medical College of Shanxi Province from June 2016 to June 2019 were retrospectively analyzed.The clinical symptoms and auxiliary examination results, combination of tumor, treatment, relapse and prognosis were analyzed.Results:There were 17 females, 3 males, the age of onset was (5.9±3.5)years, which presented acute or subacute onset, the first symptom was convulsion in 12 cases.Clinical symptoms: 18 cases of abnormal mental behavior, 18 cases of dyskinesia, 17 cases of epileptic seizure and 17 cases of language barrier.No tumor was found.The electroencephalogram was abnormal, the delta brush was visible in 4 cases, and 3 cases were recurrent cases, cranial MRI showed no significant abnormalities in 4 cases and abnormal in 16 cases.There were 8 cases of recurrence, 7 cases of single recurrence and 1 case of 3 recurrence.These 17 cases were treated with Rituximab.All 20 cases were improved, 2 cases with left epilepsy, 1 case with left hemiplegia.Conclusion:Anti-NMDAR encephalitis has a high incidence in female children and can occur in children of all ages.Convulsions are the most common first symptom.The common clinical symptoms are in order: mental behavior abnormalities, dyskinesia, seizures, and language barrier, the tumor merger rate is low, the abnormal delta brush is significant for disease severity.The recurrence rate of anti-NMDAR encephalitis is high, those who did not use second-line immunotherapy are higher.Rituximab is effective for patients with poor first-line immunotherapy and patients with recurrence.
