摘要
目的 通过比较抗髓鞘寡突胶质糖蛋白(myelin oligodendroglia glycoprotein,MOG)抗体病(MOG antibody associated disease,MOGAD)及抗N-甲基-D-天冬氨酸受体脑炎重叠综合征(overlapping syndrome of MOG antibody disease and anti-N-methyl-Daspartate receptor encephalitis,MNOS)与MOGAD、抗N-甲基-D-天冬氨酸受体脑炎(N-methyl-D-aspartate receptor encephalitis,NMDARe)的临床特点及差异,以提高对MNOS的认识。方法 回顾性收集14例MNOS患者(MNOS组),以及年龄、性别相匹配的MOGAD(MOGAD组)、NMDARe(NMDARe组)病例各14例,比较3组患者的临床表现、脑脊液检查、脑电图、磁共振成像(magnetic resonance imaging,MRI)、治疗及预后等方面的异同。结果 3组患者意识障碍和视神经炎的比例比较差异有统计学意义(P<0.05),其中MNOS组意识障碍患者比例低于NMDARe组(P<0.0167),MNOS组视神经炎的患者比例高于NMDARe组(P<0.0167)。MOGAD组有正常脑电图的患者比例最高(54.6%);NMDARe组有非特异性慢波的患者比例最高(35.7%);MNOS组有癫痫波的患者比例最高(35.7%);NMDARe组同时出现癫痫波和δ波的患者比例最高(35.7%);MOGAD组患者无δ出现。3组患者预后的比较差异无统计学意义(P>0.05)。MNOS组患者复发的比例是(21.4%)。结论 MNOS的意识障碍和视神经炎的发生率有别于MOGAD、NMDARe;癫痫波发生率较高;大部分患者预后良好,但有复发倾向。
Objective By comparing the overlap syndrome of anti myelin oligodendroglia glycoprotein(MOG)antibody associated disease(MOGAD)and anti NmethylDaspartate receptor encephalitis(MNOS)with MOGAD the clinical characteristics and differences of N methyl D aspartate receptor encephalitis(NMDARe)in order to improve the understanding of MNOS.Methods A retrospective collection of 14 MNOS patients(MNOS group),as well as 14 age and gender matched MOGAD(MOGAD group)and NMDARe(NMDARe group)cases each,was conducted to compare the clinical manifestations,cerebrospinal fluid examination,electroencephalogram,magnetic resonance imaging(MRI),treatment,and prognosis of the three groups of patients.Results There was a significant difference in the proportion of consciousness disorders and optic neuritis among the three groups(P<0.05).Among them,the proportion of consciousness disorders patients in the MNOS group was lower than that in the NMDARe group(P<0.0167),and the proportion of optic neuritis patients in the MNOS group was higher than that in the NMDARe group(P<0.0167).The proportion of patients with normal EEG in the MOGAD group was the highest(54.6%).The proportion of patients with nonspecific slow waves in the NMDARe group is the highest(35.7%).The proportion of patients with epileptic waves in the MNOS group was the highest(35.7%).The NMDARe group exhibited both epileptic waves andδThe proportion of patients with wave was the highest(35.7%).Noδwave was found in the MOGAD group.There was no significant difference in prognosis among the three groups(P>0.05).The rate of recurrence in the MNOS group was(21.4%).Conclusions The incidence of consciousness disorders and optic neuritis in MNOS is different from that in MOGAD and NMDARe.The incidence of epileptic waves is relatively high.Most patients have a good prognosis,but there is a tendency for recurrence.
作者
陈晓莉
王群
刘佳
李静
雷琦
CHEN Xiaoli;WANG Qun;LIU Jia;LI Jing;LEI Qi(Department of Neurology,Shaanxi Provincial People’s Hospital,Xi’an,Shaanxi 710068,China;Department of Neurology,Xiangya Hospital,Central South University,Changsha,Hunan 410008,China)
出处
《国际神经病学神经外科学杂志》
2023年第2期18-22,共5页
Journal of International Neurology and Neurosurgery
