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中华诊断学电子杂志 ›› 2017, Vol. 05 ›› Issue (03) : 200 -204. doi: 10.3877/cma.j.issn.2095-655X.2017.03.015

所属专题: 文献

临床研究

抗γ-氨基丁酸B型受体脑炎患者的临床及脑电图特征分析
单广振1, 陈伟1,(), 郑娟2   
  1. 1. 252000 聊城市人民医院神经内科
    2. 252000 聊城市人民医院转化医学实验室
  • 收稿日期:2017-06-29 出版日期:2017-08-26
  • 通信作者: 陈伟

Clinical characteristics and electroencephalogram pattern of anti-GABAB receptor encephalitis

Guangzhen Shan1, Wei Chen1,(), Juan Zheng2   

  1. 1. Department of Neurology, Liaocheng People′s Hospital, Liaocheng 252000, China
    2. Department of Translational Medical Laboratory, Liaocheng People′s Hospital, Liaocheng 252000, China
  • Received:2017-06-29 Published:2017-08-26
  • Corresponding author: Wei Chen
  • About author:
    Corresponding author: Chen Wei, Email:
引用本文:

单广振, 陈伟, 郑娟. 抗γ-氨基丁酸B型受体脑炎患者的临床及脑电图特征分析[J/OL]. 中华诊断学电子杂志, 2017, 05(03): 200-204.

Guangzhen Shan, Wei Chen, Juan Zheng. Clinical characteristics and electroencephalogram pattern of anti-GABAB receptor encephalitis[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2017, 05(03): 200-204.

目的

探讨抗γ-氨基丁酸B型受体(GABABR)脑炎患者脑电图(EEG)特征、临床特点及预后。

方法

回顾分析2016年4—6月在聊城市人民医院神经内科收治的经免疫调节及抗癫痫药物治疗后的3例抗GABABR脑炎患者的临床资料,总结GABABR脑炎发病不同时期头皮EEG特点。

结果

3例抗GABABR脑炎患者(女性1例,男性2例)均表现为难治性癫痫发作、精神行为异常及近期记忆力减退。3例患者EEG显示局灶慢波或痫样放电,长程视频脑电图(VEEG)记录到发病不同阶段的EEG,其中2例患者显示非惊厥性癫痫持续状(NCSE)EEG。2例胸部CT提示肺部占位。3例患者接受糖皮质激素或丙种球蛋白等免疫调节治疗。1例死亡,1例基本恢复,1例病情复发。

结论

抗GABABR脑炎患者不同时期有不同的EEG特点,抗GABABR脑炎可以继发NCSE,抗GABABR脑炎患者首发症状主要表现为难治性癫痫,部分抗GABABR脑炎患者合并肺癌。未合并肿瘤抗GABABR脑炎患者积极免疫治疗预后较好。

Objective

To observe the clinical scalp electroencephalogram (EEG) characteristics and prognostic analysis of anti-GABAB receptor encephalitis.

Methods

The clinical data of 3 patients of anti-GABAB receptor encephalitis who were treated in Neurology of Liaocheng People′s Hospital were reviewed retrospectively.

Results

The clinical manifestations of 3 patients (two male and one female) were refractory epilepsy, psychiatric behavioral symptoms and memory deficits.EEG showed focal epilepsic discharge or abnormal slow wave in 3 cases and long-term video EEG (VEEG) recorded different stages of EEG.VEEG of 2 patients with anti-GABAB receptor encephalitis were recorded during NCSE.Lung mass was found in two patients by chest CT.All patients were treated with combined first-line immunomodulatory therapies with steroids or intravenous immunoglobulin.1 patient died, 1 patient recovered and 1 patient recurred.

Conclusions

There are different EEG characteristics at different times in anti-GABAB receptor encephalitis.Three cases with anti-GABAB receptor antibody presented an initial symptom, with refractory epilepsy.Two of them accompanied with lung tumor.The patients with unincorporated lung tumor active immunotherapy can get good prognosis.

表1 3例抗γ-氨基丁酸B型受体脑炎患者的一般情况
图1 抗γ-氨基丁酸B型受体脑炎患者1脑电图图像。a图示额区阵发性θ活动;b图示左侧额颞、蝶骨电极区尖波节律;c图示额颞区阵发性σ活动或节律;d图示局灶性慢波及痫样活动消失(箭头所示)
图2 抗γ-氨基丁酸B型受体脑炎患者2脑电图图像。a图示右侧额颞区持续尖波节律;b图示右侧颞区低波幅慢波(箭头所示)
图3 抗γ-氨基丁酸B型受体脑炎患者3脑电图图像。左侧额颞区痫样放电(箭头所示)
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