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目的总结抗NMDA受体脑炎的临床表现、诊断、治疗及预后等特点,以期提高对该病的认识。方法分析3例抗NMDA受体脑炎患者的临床表现、实验室检查、影像学检查、对免疫治疗的反应及预后。结果 3例患者均表现有显著的精神症状,难治性癫痫和自主神经功能障碍,部分患者伴有运动障碍;脑脊液及血清抗NMDA受体阳性;免疫治疗有效。结论无精神病史的患者出现不明原因的精神症状伴痫性发作、记忆丧失、意识水平降低、运动障碍甚至出现中枢性通气不足,特别是伴有卵巢畸胎瘤者应警惕抗NMDA受体脑炎,及时诊断和治疗有助于抗NMDA受体脑炎患者的恢复。
Objective To summarize the clinical manifestations, diagnosis, treatment and prognosis of anti-NMDA receptor encephalitis in order to improve their understanding of the disease. Methods The clinical manifestations, laboratory tests, imaging examination, response to immunotherapy and prognosis of 3 patients with anti-NMDA receptor encephalitis were analyzed. Results All 3 patients showed significant psychiatric symptoms, refractory epilepsy and autonomic dysfunction. Some patients had dyskinesia. Cerebrospinal fluid and serum were positive for anti-NMDA receptor. Immunotherapy was effective. Conclusion Patients with no history of mental illness have unexplained psychiatric symptoms associated with seizures, memory loss, decreased levels of consciousness, dyskinesia, or even central hypoventilation. In particular, patients with ovarian teratoma should be cautioned against NMDA receptor encephalitis , Timely diagnosis and treatment of anti-NMDA receptor encephalitis in patients with recovery.