富亮氨酸胶质瘤失活1蛋白抗体阳性脑炎四例临床分析
Encephalitis with positive LGI1 antibody: a clinical analysis of 4 cases
回顾性分析2017年3月至2019年1月北京地坛医院收治的4例富亮氨酸胶质瘤失活1蛋白(LGI1)抗体阳性脑炎患者的临床资料。4例患者均为男性,年龄(42±17)岁,2例以面-臂肌张力障碍(FBDS)为主要表现,3例出现癫痫症状,均无记忆力减退,血钠水平均正常,血清LGI1抗体(+),脑脊液LGI1抗体(-)。确诊时间最长5个月。3例头颅MRI检查正常,1例示右侧基底节异常信号,治疗后病灶缩小。胸部、腹部及盆腔CT检查均未发现肿瘤。4例均采用丙种球蛋白与糖皮质激素治疗,恢复良好。LGI1抗体阳性脑炎以癫痫为主要表现,临床上中早期识别FBDS有助于早期诊断,及时治疗后恢复良好。
更多The clinical manifestations,serum and cerebrospinal fluid (CSF) results,EEG and imaging findings of 4 cases of encephalitis with positive leucine-rich glioma inactivated protein 1 (LGI1)antibody admited from March 2017 to January 2019 were retrospectively analyzed.All 4 patients were males with a mean age of (42±17) years.Two patients had faciobrachial dystonic seizure(FBDS)as the main symptom,and 3 patients had epilepsy.There were normal blood sodium and no memory deficits in all 4 patients.The LGI1 antibody was positive in the serum and negative in the CSE.The longest diagnosis time was 5 months.The head MRIs were normal in 3 patients;and abnormal signals in the right basal ganglia were found in one case,and the lesicl became smaller after the treatment.Chest CT,abdominal CT,and pelvic CT did not detect tumors.All patients were treated with gamma globulin and glucocorticoids,they all had good prognosis.LGI1 antibody-positive encephalitis is mainly characterized by epilepsy. ldentifying FBDS would be helpful for early diagnosis.Timely treatments often result in good clinical prognosis.
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