Clinical Analysis Of Autoimmune Encephalitis With Synaptoprotein-related Antibodies On The Surface Of Neurons

ObjectiveRetrospectively analyzed the clinical data of 30 patients with autoimmune encephalitis(AE)associated with neuronal surface synapsin-related antibodies.The clinical characteristics and prognosis of different types of antibody encephalitis are analyzed in combination with domestic and foreign literatures,aiming to improve clinicians’understanding of such diseases and provide reference for clinical practice..MethodsCollected from September 2017 to July 2019 in the Department of Neurology of the Second Affiliated Hospital of Nanchang University,the demographics,onset time,previous medical history,disease duration,prodromal symptoms,first symptoms,first symptoms,main symptoms,and routine biochemistry of 30 patients admitted to the Department of Neurology,the Second Affiliated Hospital of Nanchang University And CSF antibody detection,auxiliary examination,treatment plan and prognosis and other data,using SPSS 22.00 for statistical data analysis.Results1.In this group of 30 patients,28 cases had acute onset,2 had subacute onset.10 patients(33%)had different prodromal symptoms,mainly fever and headache.2.In this group of 30 patients,the initial symptoms of 24 patients(80%)were the limbic encephalitis symptoms,of which 9(30%)patients had onset of epileptic seizures,and 5(17%)patients were with cognitive impairment.6 patients(20%)had onset of psychiatric behavior,and 4 patients(14%)had onset of consciousness.There were 6 patients(20%)with non-specific symptoms as the initial symptom,such as dizziness,Limb weakness,headache.3.In this group of 30 patients,90%of the patients had symptoms of limbic system involvement throughout the course of the disease.and the symptoms of seizures,disturbance of consciousness,and movement disorders are statistically different between the anti-NMDAR、AMPAR and GABA_BR encephalitis groups(P<0.05).There were no significant differences among the three groups in cognitive dysfunction,mental and behavioral abnormalities,sleep disorders,autonomic dysfunction and central hypoventilation(P>0.05).4.In this group of 30 patients,8(27%)patients had tumors,of which 4(13%)anti-NMDAR encephalitis patients had left adrenal adenoma,ovarian teratoma,and2(6%)anti-GABA_BR encephalitis patients was found lung cancer(squamous epithelial cell carcinoma),2(6%)anti-AMPAR encephalitis patients was respectively found lung cancer and malignant thymoma.5.There were statistically significant differences between prognosis poor and good group in terms of age,length of hospitalization,duration of initiation of immunotherapy,antibody titer,and combined tumor(P<0.05).There was no statistical difference among the two groups in gender,cerebrospinal fluid pressure,cerebrospinal fluid cell number,and cerebrospinal fluid protein(P>0.05).There was a statistically significant difference between prognosis poor and good group in the symptoms of fever,status epilepticus,disturbance of consciousness,and central hypoventilation(P<0.05),while in seizures,recognition disorders,abnormal mental behavior,and sleep disorders were not statistically significant(P>0.05).Conclusion1.Synapsin-related antibodies on neuronal surface autoimmune encephalitis is mainly based on symptoms of limbic system involvement.Anti-AMPAR encephalitis is more prone to physical disability,and anti-GABA_BR encephalitis is more prone to seizures and consciousness disorders.Some AE patients may only have some atypical related symptoms,such as syncope,headache and physical activity disorders.For these patients,we also need to do related antibody screening.2.Old age,early initiation of immunotherapy,high antibody titers,combined tumors,the appearance of status epilepticus,central hypoventilation,and unconsci-ousness symptoms are closely related to the poor prognosis of AE patients.