脑电图表现为δ刷的抗代谢型谷氨酸受体5脑炎一例

来源 :中华神经科杂志 | 被引量 : 0次 | 上传用户:wtt014789
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抗代谢型谷氨酸受体5(mGluR5)脑炎为一种罕见的自身免疫性抗体介导的中枢神经系统疾病,目前暂无亚洲病例报道。我院收治1例51岁男性患者,临床表现为精神障碍、癫痫及脑神经(Ⅶ)损害,视频脑电图检查可见δ刷、双侧颞区尖波及尖慢波,脑脊液及血清抗mGluR5抗体IgG阳性。患者先后接受了一线(激素、丙种球蛋白)及二线(利妥昔单抗)免疫治疗,但最终死于肺部感染所致的呼吸衰竭及心跳骤停。“,”Encephalitis with metabotropic glutamate receptor 5 (mGluR5) antibodies is a rare autoimmune antibody-mediated central nervous system disease. A 51-year-old Chinese male was admitted to the Affiliated Brain Hospital of Nanjing Medical University with clinical manifestations of abnormal mental behavior, epilepsy, and cranial nerve paralysis (Ⅶ). Testing of cerebrospinal fluid and serum for antibodies to mGluR5 was positive (1∶32 and 1∶10) on cell based assay. Sharp wave and slow sharp wave in the bilateral temporal regions and extreme delta bush were seen on video-electroencephalogram evaluation. Although the patient was treated with hormones, immunoglobulin, and rituximab successively, he eventually died of respiratory failure and cardiac arrest due to a lung infection.
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