天津医药 ›› 2020, Vol. 48 ›› Issue (6): 551-554.

• 临床研究 • 上一篇    下一篇

LGI1抗体脑炎的临床特点分析 #br#

赵志红   

  1. 天津市环湖医院神经内科(邮编 300350
  • 收稿日期:2019-07-09 修回日期:2020-04-26 出版日期:2020-06-15 发布日期:2020-06-15
  • 通讯作者: 赵志红 E-mail:zhaozhihong1106@163.com

Clinical analysis of LGI1 antibody encephalitis #br#

ZHAO Zhi-hong #br#   

  1. Department of Neurology, Tianjin Huanhu Hospital, Tianjin 300350, China
  • Received:2019-07-09 Revised:2020-04-26 Published:2020-06-15 Online:2020-06-15

摘要: 摘要:目的 探讨富亮氨酸胶质瘤失活1蛋白(LGI1)抗体脑炎的临床特点。方法 回顾性分析2014年3月— 2016年12月天津市环湖医院神经内科收治的3例LGI1抗体脑炎的临床资料,总结其临床特征。结果 3例患者均 为中年男性,临床表现为认知障碍、不自主运动、睡眠障碍。其中,例1、3有精神症状,例2有前驱感染及面臂肌张力 障碍(FBDS),例2、3有癫痫发作及低钠血症。所有患者头MRI可见异常信号,主要累及单侧或双侧颞叶内侧、海马。 血及脑脊液LGI1抗体均为阳性,均未发现肿瘤,给予一线免疫治疗(激素和丙种球蛋白),症状明显缓解或改善。结论 以认知障碍、不自主运动、精神异常、睡眠障碍及低钠血症为主要表现的中老年男性脑炎患者,应警惕LGI1抗体 脑炎的可能,需行脑脊液抗体检测明确诊断,早期免疫治疗可明显改善预后。

关键词: 富亮氨酸胶质瘤失活1蛋白, 脑炎, 面臂肌张力障碍, 海马, 低钠血症

Abstract: Abstract: Objective To explore the clinical characteristics of leucine-rich glioma inactivated protein 1 (LGI1) antibody encephalitis. Methods The clinical data of three cases of LGI1 antibody encephalitis were retrospectively collected in the department of neurology of Tianjin Huanhu Hospital from 2014 to 2016, and the clinical characteristics were summarized. Results All the three patients were middle-aged males, and their clinical manifestations were cognitive dysfunction, involuntary movement and sleep dysfunction. Among the patients, two experienced mental symptoms, one showed preceding infection and facial dystonic seizures (FBDS), two experienced seizures and hyponatremia. MRI showed abnormalities in all the patients, mainly involving the unilateral or bilateral medial temporal lobe and the hippocampus. LGI1 antibody detection in blood and cerebrospinal fluid was positive. Tumors were not found by all examinations. Symptoms improved or alleviated after immunotherapy (steroids and intravenous immunoglobulin). Conclusion For the middle-aged and old male encephalitis patients with cognitive dysfunction, involuntary movement, psychiatric symptoms, sleep dysfunction and hyponatremia as the main manifestations, it should be alert to the possibility of LGI1 antibody encephalitis. Cerebrospinal fluid antibody detection is required for definite diagnosis. Early immunotherapy can significantly improve the clinical prognosis.

Key words: leucine-rich glioma inactivated protein 1, encephalitis, faciobrachial dystonic seizures, hippocampus, hyponatremia