[1]李志方,董丽彬,孙彬彬,等.富亮氨酸胶质瘤失活1蛋白抗体阳性边缘叶脑炎的临床特点并文献复习[J].卒中与神经疾病杂志,2017,24(05):444-446+449.[doi:10.3969/j.issn.1007-0478.2017.05.015]
 Li Zhifang,Dong Libin,Sun Binbin,et al.Clinical analysis of positive leueine-rich glioma inactived-1 antibody associated limbic encephalitis and literature review[J].Stroke and Nervous Diseases,2017,24(05):444-446+449.[doi:10.3969/j.issn.1007-0478.2017.05.015]
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富亮氨酸胶质瘤失活1蛋白抗体阳性边缘叶脑炎的临床特点并文献复习()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第24卷
期数:
2017年05期
页码:
444-446+449
栏目:
论 著
出版日期:
2017-10-26

文章信息/Info

Title:
Clinical analysis of positive leueine-rich glioma inactived-1 antibody associated limbic encephalitis and literature review
文章编号:
1007-0478(2017)05-0444-04
作者:
李志方董丽彬孙彬彬樊双义
100071 北京,军事医学科学院附属医院神经内科
Author(s):
Li ZhifangDong LibinSun Binbinet al.
Department of Neurology,Affiliated Hospital of Academy of Military Medical Sciences,Beijing 100071
关键词:
抗富亮氨酸胶质瘤失活1蛋白 边缘叶脑炎 免疫治疗
Keywords:
Leueine-rich glioma inactived-1 antibody Limbic encephalitis Immune therapy
分类号:
R512.3
DOI:
10.3969/j.issn.1007-0478.2017.05.015
摘要:
目的 探讨富亮氨酸胶质瘤失活1蛋白(LGI1)抗体阳性边缘叶脑炎的临床特点。方法 对本院收治的1例LGI1抗体阳性的边缘叶脑炎患者的诊治过程进行回顾性分析并复习相关文献。结果 患者为青年女性,亚急性起病,临床主要表现为记忆力下降、癫痫、闭经、情绪障碍。血和脑脊液LGI1抗体阳性; MRI检查T2及Flair序列可见双侧颞叶内侧、海马高信号病灶; PET-CT示双侧颞叶内侧、海马代谢活性对称性降低。经激素和免疫球蛋白联合治疗,疗效显著。结论 LGI1抗体阳性边缘叶脑炎以记忆力下降、癫痫发作为主要临床表现; 病灶主要累及双侧颞叶内侧、海马; 具有较好的免疫治疗效果,及时的诊断及治疗有助于患者的恢复。
Abstract:
ObjectiveTo explore the clinical features and therapeutic outcomes of positive leueine-rich glioma inactived-1 antibody(Anti-LGI1)associated 1imbic encephalitis.Methods One case with anti-LGI1 1imbic encephalitis was analyzed retrospectively,and the literature was reviewed.Results A young woman was admitted to the hospital due to subacute onset of declination of recent-memory function,epilepsy,mood disorder and amenorrhea.LGI1 antibody both in blood and cerebrospinal fluid was positive.T2 or flair MRI scans revealed abnormal signals in bilateral medial temporal lobes and hippocampus.While PET-CT showed the decreased metabolism of bilateral medial temporal lobes and hippocampus.And glucocorticoid combined intravenous immunoglobulins(IVIg)showed remarkable outcome.Conclusion Anti-LGI1 1imbic encephalitis was characterized by memory function impairment,epilepsy,mood disorder with specific LGI1 antibody.Bilateral medial temporal lobes and hippocampus were major affected while immune therapeutic effect was significant.Prompt diagnosis and treatment might be helpful for patients in recovery.

参考文献/References:

[1] Lai MZ,Huijbers MG,Lancaster E,et al.Investigation of LGI1 as the antigen in limbic encephalitis previously attributed to Potassium channels: a case series[J].Lancet Neurol,2010,9(8):776-785.
[2] 金丽日,柳青,任海涛,等.富亮氨酸胶质瘤失活1蛋白抗体阳性边缘系统脑炎一例临床特点[J].中华神经科杂志,2013,46(7):461-464.
[3] Honnorat J.Is autoimmune limbic encephalitis a channelopathy?[J].The Lancet Neurology,2010,9(8):753-755.
[4] Ohkawa T,Fukata Y,Yamasaki M,et al.Autoantibodies to epilepsy-related LGI1 in limbic encephalitis neutralize LGI1-ADAM22 interaction and reduce synaptic AMPA receptors[J].J Neurosci,2013,33(46):18161-18174.
[5] Shin YW,Lee ST,Shin JW,et al.VGKC-complex/LGI1-antibody encephalitis: clinical manifestations and response to immunotherapy[J].J Neuroimmunol,2013,265(1/2):75-81.
[6] Irani SR,Michell AW,Lang B,et al.Faciobrachial dystonic seizures precede Lgi1 antibody limbic encephalitis[J].Ann Neurol,2011,69(5):892-900.
[7] Irani SR,Vincent A.The expanding spectrum of clinically-distinctive,immunotherapy-responsive autoimmune encephalopathies[J].Arq Neuropsiquiatr,2012,70(4):300-304.
[8] Szots M,Marton A,Kover F,et al.Natural course of LGI1 encephalitis: 3-5 years of follow-up without immunotherapy[J].J Neurol Sci,2014,343(1/2):198-202.
[9] 唐鹤飞,刘玉坤,张然,等.富亮氨酸胶质瘤失活1蛋白抗体阳性边缘系统脑炎7例临床分析[J].中国神经免疫学和神经病学杂志,2015,22(3):188-190.
[10] Asztely F,Kumlien E.The diagnosis and treatment of limbic encephalitis[J].Acta Neurol Scand,2012,126(6):365-375.
[11] Gao L,Liu A,Zhan S,et al.Clinical characterization of autoimmune LGI1 antibody limbic encephalitis[J].Epilepsy Behav,2016,56:165-169.

更新日期/Last Update: 2017-10-20