| Objectives:The aim of this study is to supply information for clinical application by analyzing the general information, clinical manifestations, laboratory examinations, imaging, electroencephalogram (EEG), treatments, therapeutic effects of 11 autoimmune encephalitis (AE) patients and discussing the epidemiological features, pathogenesis, clinical characteristics, auxiliary examinations, diagnosis, treatment and prognosis of AE with related literatures in the domestic and abroad.Materials and methods:11 patients with final diagnosis in the department of neurology of Shandong university Qilu hospital from March 2015 to February 2016 were included in this study. The general information, clinical manifestations, cerebral magnetic resonance Imaging (MRI), EEG results, cerebrospinal fluid (CSF) and serum tests, treatment and effects of these patients were collected. The information of these 11 AE patients was analyzed retrospectively. These patients were divided into different groups according to different types of antibodies. This study described the characteristics of each group in terms of frequency and percentage of individual test.Results:There were 11 cases of AE that fulfill the clinical features of encephalitis with positive expression of neuronal surface antibodies (NSAbs) in the CSF, including 7 cases of Anti-NMDAR encephalitis,3 cases of Anti-LGI1 encephalitis and 1 case of Anti-GABABR encephalitis.7 male and 4 female patients, aging from 19 to 71 years old were included in this study. Main clinical findings were psychological symptom, epileptic seizures, cognitive dysfunction, agitation and confusion. The laboratory tests of the serum biochemistry were abnormal in 6 patients. Hyponatremia or hypochloridemia were found in 4 patients. Positive expressions of tumor markers were detected in 6 cases indicating the possibility of underlying tumors. The abnormalities were found in the CSF including leukocytosis with maximum of 120×106/L, normal or high protein content with maximum of 0.79g/L. Abnormal findings in MRI were found in 6 cases, including focal ischemic degeneration was showed in 3 cases’. Abnormal signal in hippocampus and temporal lobe was shown in 1 patient. Abnormalities in frontal, parietal and occipital lobes were found in 1 patient. Cerebral arteriosclerosis was shown in 1 patient. The MRI of the other 5 patients was normal. Tumor screening was carried out in these patients showing that hysteromyoma was found in one of them, and lung cancer was found in another patient, but pathological examination was not conducted in neither of them to confirm the diagnoses.10 patients showed abnormal EEG. Only 1 patient showed a normal EEG.8 brush slow activity could be detected in 1 patient. All the patients were treated with immunosuppressive therapies including glucocorticoid and intravenous immunoglobulin (IVIG). Almost all the patients responded to immunosuppressive therapy, but partial cognitive dysfunctions remained in some patients before leaving the hospital.Conclusions:The clinical manifestations of AE are mainly psychological symptoms, seizures, cognitive dysfunction, agitation and confusion. Serum test may help to exclude other diseases and screen tumors. The abnormalities in CSF include leukocytosis, normal or high protein content. MRI shows normal or limbic encephalitis, and result of EEG always is abnormal, but not specific. However, it is important to exclude other diseases. Nowadays, there are no diagnostic criteria of AE, so AE is diagnosed depending on detailed history and auxiliary examinations. Positive NSAbs can help to confirm the diagnosis. Immunosuppressive therapy is applied in AE. Early management of tumors is necessary. |
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