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目的分析抗GABA(B)R脑炎临床,影像学及脑电图(EEG)特征。方法 5例血清和脑脊液(CSF)抗GABA(B)R抗体阳性的抗GABA(B)R脑炎,分析CSF白细胞数、头颅磁共振(MRI)、24h长程视频脑电图(VEEG)和预后特点。结果 5例抗GABA(B)R脑炎中,精神行为异常2例,意识障碍2例,CSF白细胞数增高4例,癫痫发作5例,其中癫痫持续状态4例(80%)。24h VEEG监测3例各导可见多量阵发性长程持续5~30s、4~6Hzθ节律,并前额、额、前颞可见尖波或复合性慢波。未见异常2例。头颅MRI异常1例,累及海马、额叶皮质。呼吸衰竭1例,行气管插管,未用呼吸机辅助呼吸。1例合并血和CSF抗Hu抗体阳性并发肺癌。随访半年死亡3例(60%),完全正常2例(40%)。结论抗GABA(B)R脑炎是以癫痫发作为特点的疾病,本组5例患者均早期出现严重的癫痫发作。预后与癫痫的严重程度和是否合并肿瘤有关。
Objective To analyze the clinical, imaging and electroencephalographic (EEG) features of anti-GABA (B) R encephalitis. Methods Five anti-GABA (B) R anti-GABA (B) R encephalitis positive in serum and cerebrospinal fluid (CSF) were analyzed. The number of CSF white blood cells, magnetic resonance imaging (MRI), long- Features. Results In 5 cases of anti-GABA (B) R encephalitis, there were 2 cases of abnormal mental behavior, 2 cases of disturbance of consciousness, 4 cases of increased CSF leucocyte count, 5 cases of epileptic seizures, including 4 cases (80%) of status epilepticus. 24h VEEG monitoring of the three cases showed a large number of paroxysmal long-range continuous 5 ~ 30s, 4 ~ 6Hz theta rhythm, and forehead, frontal and temporal visible spike or compound slow wave. No abnormalities in 2 cases. A case of abnormal cranial MRI, involving the hippocampus, frontal cortex. One case of respiratory failure, endotracheal intubation, without ventilator-assisted breathing. One case of combined blood and CSF anti-Hu antibody positive lung cancer. Follow-up six months of death in 3 cases (60%), completely normal in 2 cases (40%). Conclusions Anti-GABA (B) R encephalitis is a disease characterized by seizures. All 5 patients in this group had severe seizures early. Prognosis and the severity of epilepsy and whether the merger of the tumor.