Analysis Of Clinical Characterization Of Movement Disorders In Autoimmune Encephalitis

Objective:Objective to analyze the characteristics of movement disorders in patients with autoimmune encephalitis,and to deepen the understanding of clinical doctor.Method:This study collected from September 2014 to August 2016 in the first hospital of Jilin University,Department of Neurology,diagnosed with autoimmune encephalitis and 39 cases with movement disorders of patients,all patients are divided into 3 groups,including anti-NMDA receptor encephalitis group N,anti LGI1 positive group and L group for anti-GABAB receptor encephalitis G group.The general information of the patients was collected,including clinical manifestations,especially movement disorders manifestations,MRI,CSF,EEG,treatment and efficacy.(1)movement disorders manifestationsAccording to the recognized terminology,the manifestations of movement disorders will be divided into tremor,choreoathetosis,ballism,and orofacial–lingual dyskinesia and so on.(2)Inclusion criteria:a.Meet the diagnostic criteria of encephalitis include disorders of consciousness or mental and behavior disorder,and there exists new manifestations of nervous system damage,MRI abnormalities,seizures,fever,CSF abnormalities,abnormal EEG in at least 2.b.CSF or serum NMDA receptor antibody,anti GABAB receptor antibody or anti LGI1 antibody positive.(3)Exclusion criteria:a.The clinical manifestations of movement disorders or encephalitis in children and adult patients are different,and the patients in our hospital are mainly adults,so children less than 14 years old are excluded.b.Exclusion of viral encephalitis,glioma,neurosyphilis,metabolic encephalopathy,drug poisoning,rheumatic disease involving the nervous system,cerebrovascular disease,mitochondrial diseases and etc.The measurement data is consistent with the normal data as the mean ± standard deviation,and the T test is used to test.Fisher exact tests or Pearson exact tests for categorical variables are conducted to compare groups.Two-sided values of p < 0.05 are considered statistically significant.All statistical analyses are performed in SPSS Version19.0.Result:(1)Three groups of patients are statistically analyzed,P < 0.05,the age of L group and G group is higher than N group.The patients are divided into two groups according to the movement disorders.The age and sex of the two groups are statistically analyzed,P>0.05,and there is no significant difference.The movement disorders of the three groups of patients are statistically analyzed,P < 0.05,L group and G group of onset age are higher than the age of N group.(2)64.1% of the patients in the three groups with movement disorders,in which the most common form of abnormal movement of tremor and orofacial–lingual dyskinesia.The most common forms of abnormal exercise were statistically analyzed between the three groups,P were 0.447 and 0.536,respectively.(3)Three groups of abnormal motion time mean were 15.8±6.39 days,20±9 days,47.33 ± 28.02 days,L group and N group,L group and G group,G group and N group respectively for statistical analysis,the P are 0.002,0.513 and 0.016,respectively.so the N group movement disorders duration is L group and G group lasted for a long time.The average time of tremor in group L and group N was 14±5.89 days and 48.63 ±33.10,p=0.174,no statistical significance.In the L group and the N group,the duration of oral and mandibular muscle tension was 17 ± 6.88 days and 61 ± 29.2 days,respectively.The statistical analysis between L and N,p < 0.05,and the duration of the orofacial–lingual dyskinesia is higher than that of the group L.(4)The three groups of patients are divided into 2 groups according to with/without movement disorders,statistically analyzed respectively,and the P > 0.05,there is no statistical significance.(5)Three groups of patients with slow wave EEG are the main.Each group is divided into two groups according to whether the abnormal movement,the chi square test was used,the p>0.05,there is no statistical significance.(4)Statistical method:(6)Three groups of patients with or without movement disorders in patients with lumbar puncture,the number of white blood cells and protein,P > 0.05,no statistical significance.(7)L group against N group,G group,respectively.the P are 0.002 and 0.016,respectively,with statistical significance,L group was significantly higher than the G group and the N group,while the G group and L group compared to P,no statistical significance.(8)All the patients are given immunosuppressive therapy and symptomatic supportive treatment,whether or not they had abnormal exercise.Conclusion:(1)Autoimmune encephalitis about 2/3 patients with movement disorders,movement disorders is the most common form of orofacial–lingual dyskinesia and tremor,and orofacial–lingual dyskinesia in anti NMDA receptor encephalitis with a longer time.(2)The effect of immunotherapy on anti NMDA receptor encephalitis,anti GABAB receptor encephalitis and anti LGI1 encephalitis combined with abnormal movement was good.