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抗富亮氨酸胶质瘤失活蛋白1抗体相关脑炎临床特征分析

PAN He-yue, ZHONG Ling, LI Yan,WANG Shou-yong,SHI Xiang-song,XU Jian-yang

Chinese Journal of Contemporary Neurology and Neurosurgery（2023）

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Abstract
目的 总结抗富亮氨酸胶质瘤失活蛋白1(LGI1)抗体相关脑炎临床特点.方法与结果 江苏省淮安市第三人民医院2018年3月至2022年10月诊断与治疗13例抗LGI1抗体相关脑炎患者,首发症状分别为局灶性癫痫发作6例、精神症状3例、近事记忆减退2例、面-臂肌张力障碍发作2例;10例血清抗LGI1抗体阳性,2例脑脊液抗LGI1抗体阳性;4例伴低钠血症;9例MRI异常,表现为海马FLAIR成像高信号3例、腔隙性梗死4例、皮质及皮质下轻度萎缩1例、额叶皮质下白质缺血性改变1例;10例脑电图异常,表现为局灶性痫样放电5例,慢波增多5例;12例行免疫治疗,6例同时行抗癫痫发作治疗;10例预后良好,3例预后不良.结论 抗LGI1抗体相关脑炎临床主要表现为癫痫发作、精神障碍、近事记忆减退,面-臂肌张力障碍发作为其特征性表现,可伴低钠血症,应尽早启动免疫治疗.
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Key words
Encephalitis,Autoimmune diseases of the nervous system,Dystonic disorders,Hyponateramia,Immunotherapy
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