抗N_甲基_D_天冬氨酸受体脑炎_一种新型自身免疫性脑炎

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1、·12·ᇏݓགྷսപࣜࠥѨᄖᆽ2013୍1ᄅ13ज1௹ChinJContempNeurolNeurosurg,January2013,Vol.13,No.1·ህีࢃቖ·ॆN⁃ࡊࠎ⁃D⁃฿׫μූ൳ุଷကğ၂ᇕྍ྘ሱദ૧ၦྟଷကӧཟफ৙ཕ}ᅋေ~ॆN⁃ࡊࠎ⁃D⁃฿׫μූ൳ุčNMDARĎଷက൞ଢభࢠ൳ܱᇿሱദ૧ၦྟଷကđॖϴࠇ҂ϴ੸ӗࠐ෸ਿbਢԵіགྷЇওཁᇷభ౺ۚಣaࣚപᆡሑaᮖቔaၩ്ᅰθa१൭ᄎ׮ᅰθࠣሱᇶപࣜۿିᅰθĠଷࠬ၁ބ࿓ॆNMDARॆุ࡟ҩӯဝྟّႋđଷ׈๭ӯหၳྟoδ඗pіགྷbᄪ௹ീྛᇖਿ్Ԣބ૧ၦၝᇅ࠴ᇍਏႵིbЧ໓୅ࣼॆNMDARଷကѨࠏᇅaਢԵіགྷaڣᇹ࡟Ұ࿹࣮ࣉᅚࣉྛ

2、ۀඍb}ܱ࡯Ս~൳ุđN⁃ࡊࠎ⁃D⁃฿׫μූĠଷကĠሱദ૧ၦࠥѨĠሸඍAnti⁃N⁃methyl⁃D⁃aspartatereceptorencephalitis:anewautoimmuneencephalitisCHENXiang⁃jun,LIXiangDepartmentofNeurology,HuashanHospital,FudanUniversity,Shanghai200040,ChinaCorrespondingauthor:CHENXiang⁃jun(Email:xiangjunchen@hotmail.com)}Abstract~Anti⁃N⁃methyl⁃D⁃asp

3、artate(anti⁃NMDA)receptorencephalitisisanewcategoryoftreatableencephalitisassociatedwithanti⁃NMDAreceptorantibody,whichattractsmoreandmoreattentionrecently.Itisclinicallycharacterizedbyprodromalfever,schizophrenia⁃likepsychiatricsymptoms,seizures,disturbanceofconsciousness,dyskinesia(particularl

4、yorofacial),andautonomicdysfunction,whichoftenoccurinyoungfemaleswithovarianteratomas.Autoantibodiestotheanti⁃NMDAreceptorinserumandcerebrospinalfluidarepositive.Electroencephalogram(EEG)oftenrevealsdiffuseδslowingwithoutparoxysmaldischarges,onwhich"δrush"isconsideredasspecificcharacteristicinso

5、mepatients.Combinedtherapyincludingtumorresectionandimmunotherapyisrecommended.Theupdatesinmechanisms,clinicalmanifestationsanddiagnosticexaminationsassociatedwithanti⁃NMDAreceptorencephalitiswillbediscussedinthisreview.}Keywords~Receptors,N⁃methyl⁃D⁃aspartate;Encephalitis;Autoimmunediseases;Rev

6、iewŀ2łॆN⁃ࡊࠎ⁃D⁃฿׫μූ൳ุčNMDARĎଷက൞၂ିᅰθbгᆀᄝЧ໓ᇏđ୅ࣼଢభݓଽຓܱႿᇕሱദ૧ၦྟᇏ൷പࣜ༢๤ۋಙྟࠥѨđ୍࣍টᄀॆNMDARଷက࿹࣮ࣉᅚࣉྛۀඍbটᄀ൳ܱᇿbॆNMDARଷကቋԚӈԛགྷႿϴႵ၂aѨࠏᇅ੸ӗࠐ෸ਿظ๠ࠇ୯ྟߑᆀđՎުႵܱӮ୍ଳྟ࣐ܵଢభؓॆNMDARଷကѨࠏᇅഉ҂ૼࠣ҂ϴᇖਿॆNMDARଷကѨ২္੤࿃࡮ᇭ໓ངಒđ֌ਢԵࠣൌဒ൩࿹࣮नіૼॆNMDARॆุູŀ3łБđቋ࣍ڸ࿐նگඋ޿೶၄ჽപࣜଽ॓ᄝ၂ቆఃᇁѨၹሰđቋԚႮDalmauሱ4২੸ӗࠐ෸ਿਢԵᆐ؎ູoଷကpࠇoଷѨp࿸ᇗᇏ൷പࣜ༢๤ߑᆀݚઔപࣜჭ஡အ໾ᇏགྷᆃᇕྍ྘പࣜჭۋಙྟࠥѨߑᆀ

7、ଷࠬ၁ࠇ࿓ᇏ࡟ԛॆNMDAR༥Іଇॆჰ൳ุbNMDARቔູᇏ൷പࣜ༢๤ྖٹŀ1łॆุđਢԵіགྷЇওཁᇷభ౺ۚಣaࣚപᆡሑaྟപࣜ־ᇉܡμූ৖ሰ྘൳ุ࿰྘đᄝപࣜ༢๤ᮖݖೂđႨቔ࡯ܱߨᇏӮྙਫ਼߭ჭࣜപࠣტۿࣜപᇶሱބθᅰ׮ᄎ१൭aθᅰ്ၩaቔŀ4łࠗࠃॖᇁᮖቔaӺշaଷቁᇏਢԵіགྷĠŀ5łۿିࢆᄵॖԛགྷࣚപٳਚᆡဢᆡሑbᄪ௹ਢԵdoiğ10.3969/j.issn.1672⁃6731.2013.01.005ቔᆀֆ໊ğ200040ഈݚđگն࿐ڸඋ޿