Twenty Cases Of Patients With Autoimmune Encephalitis And Literature Review

Objectives:By combining and comparing the domestic and foreign literature which were published in the latest,we integrated and comprehensively analysis the paper collection of 20 patients with autoimmune encephalitis(Autoimmuneencephalitis,an AIE)for general information,clinical situation,laboratory tests,imaging data,EEG(Electroencephalogram.EEG)manifestations,treatment and curative effect which is good or bad,maximize the summary of the various types of an AIE epidemiological data,specific pathogenesis,typical clinical manifestations,test results,examination,final diagnosis,treatment and prognosis of different in detail,for providing powerful reference for clinical practice.Materials and methods:From March 2015 to September 2017,the first affiliated hospital of Nanchang University neurology hospital wards were treated 20 patients finally diagnosed AIE,this article lists the patient’s general information,clinical infection situation and brain Magnetic Resonance Imaging,EEG,CSF(Cerebrospinal fluid,CSF)and serological examination,treatment and curative effect which is good or bad.Based on statistical principle,we retrospectively analysis clinical data of 20 patients.Because the cerebrospinal fluid and serum antibody of type of each patient to detect is not the same,so patients can be divided into some kind of an AIE,while depending on the frequency and percentage of patients with clinical data at the same time,we explore the laws of the various kinds of autoimmune encephalitis patients.Results:In 20 patients hospitalized in the cerebrospinal fluid,all can be found antibody on the surface of nerve cells(Neuronal surface antibodies,NSAbs),including 12cases of Anti—NMDAR encephalitis,4 cases of Anti—GABABR encephalitis,2cases of Anti—AMPAR encephalitis and 2 cases of Anti-LGI 1 encephalitis.There are16,including 2 patients exist below normal sodium and chlorine.In terms of tumors,8patients have higher than normal blood indicators,while the patient could also be found no tumor cells in the body.White blood cells in the cerebrospinal fluid may be less or more,less patient can be normal,some patients may have 280 x 10~6/L white blood cells,protein distribution difference is very big,which can appear even 2485mg/L.Head MRI male patient:female patients was 9:11,the youngest was 16 years old,and the largest can be 66 years old.The patient’s clinical symptoms include mental disorders,epileptiform seizure,degree of cognitive decline,grumpy or mind which is not clear.MRI examination can be found that six patients head results have change,in which three had chronic ischemia,the others’head result is on both sides of the frontal and parietal,part of the cingulate gyrus,on both sides of the medial part of the temporal lobe,bilateral basal ganglia region,temporal lobe,left caudate nucleus,bilateral temporal lobe underside head and insula abnormal signal.For patients with chest radiographic findings,3 patients were found to benign tumor.The distribution of abnormal electroencephalogram(EEG)for patients were abnormal discharge,mild,moderate,an abnormal-severe limits and electroencephalogram(EEG).All of the patients during hospitalization is mainly treated by glucocorticoids and IVIG.Condition in the hospital than before have improved after treatment when patients left the hospital.Some patients’symptoms still had not fully recovered to normal levels,including poor execution,cognitive decline and spirit trance,etc.Conclusion:Degree of mental disorders,epileptiform seizure,cognitive decline,irritable is autoimmune encephalitis patient’s main symptoms.Blood tests carried out on the patient and tumor screening,in order to better exclude of diagnosis,is better for other similar disease in the differential diagnosis.In the cerebrospinal fluid,leukocyte count and protein content were abnormal.Normal head MRI findings that can appear in the examination,magnetic resonance performance also can appear at the edge of the leaf encephalitis in the examination.Patients’EEG results is different from normal performance.On the diagnosis,all countries combined with their own clinical data,formulate the corresponding diagnostic criteria.Finally by the history,signs,and finding the specific antibody in cerebrospinal fluid,the patients’diagnosis can be confirmed.Immunotherapy is the main therapy.If there is a tumor,tumor should also be processed.