Analysis in clinical features of 28 autoimmune encephalitis patients with mental disorders as initial symptoms

XU Xiaolong; FU Jinhua

doi:10.7619/jcmp.20201723

Journal of Clinical Medicine in Practice > 2021 > 25(7): 55-58, 62. > DOI: 10.7619/jcmp.20201723

XU Xiaolong, FU Jinhua. Analysis in clinical features of 28 autoimmune encephalitis patients with mental disorders as initial symptoms[J]. Journal of Clinical Medicine in Practice, 2021, 25(7): 55-58, 62. DOI: 10.7619/jcmp.20201723

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Analysis in clinical features of 28 autoimmune encephalitis patients with mental disorders as initial symptoms

XU Xiaolong¹,
FU Jinhua^2, ,

1.
School of Clinical Medicine, Hunan University of Traditional Chinese Medicine, Changsha, Hunan, 410007
2.
Department of Psychiatry, Brain Hospital of Hunan Province, Changsha, Hunan, 410007

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Received Date: December 17, 2020
Available Online: April 20, 2021
Published Date: March 31, 2021

Graphical Abstract

Abstract

Abstract

Objective To summarize the clinical features and treatments of autoimmune encephalitis (AE) patients with mental disorders as initial symptoms.
Methods The clinical manifestations, auxiliary examinations and treatments of 28 AE patients with mental disorder as initial symptoms were analyzed retrospectively.
Results Among the 28 patients, 25 cases were encephalitis with positive immunoglobulin G (IgG) of anti-glutamate receptor (NMDAR) antibody, of whom 5 cases were complicated with ovarian cyst or teratoma. Two cases were encephalitis with positive IgG of anti contactin-associated protein receptor 2 (CASPR2) antibody. One case was encephalitis with positive IgG of gamma aminobutyric acid type B receptor (GABABR) antibody. With the progress of the disease, 17 patients had seizures, and 14 patients had different degrees of disturbance of consciousness. Most patients had abnormal electroencephalogram. Finally, 26 patients were treated with first-line immunotherapy, 25 patients had good effect, and one patient had no effect.
Conclusion For patients with mental disorders as initial symptoms, if they have epilepsy, disturbance of consciousness and other symptoms, AE should be highly suspected, and the head magnetic resonance imaging (MRI), electroencephalogram, cerebrospinal fluid examination and other related examinations should be performed as soon as possible. If AE is diagnosed, immunotherapy and other symptomatic treatments should be given as soon as possible to improve the prognosis of patients.
- autoimmune encephalitis,
- mental disorders,
- initial symptoms,
- onset of epilepsy,
- disturbance of consciousness

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References (17)

References

[1]	吉木舍.自身免疫性脑炎研究进展[J].中风与神经疾病杂志, 2018, 35(10):956-957. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFSJ201810027.htm
[2]	中华医学会神经病学分会.中国自身免疫性脑炎诊治专家共识[J].中华神经科杂志, 2017, 50(2):91-98.
[3]	古祺, 毛悦时.自身免疫性脑炎的新类型与新进展[J].中国临床医学, 2015, 22(6):832-836. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYX201506034.htm
[4]	DALMAU J, ROSENFELD M R. Autoimmune encephalitis update[J]. Neuro-Oncology, 2014, 16(6):771-778. doi: 10.1093/neuonc/nou030
[5]	MIKASOVA L, DE ROSSI P, BOUCHET D, et al. Disrupted surface cross-talk between NMDA and Ephrin-B2 receptors in anti-NMDA encephalitis[J]. Brain, 2012, 135(pt 5):1606-1621. http://brain.oxfordjournals.org/content/135/5/1606
[6]	TITULAER M J, MCCRACKEN L, GABILONDO I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis:an observational cohort study[J]. Lancet Neurol, 2013, 12(2):157-165. doi: 10.1016/S1474-4422(12)70310-1
[7]	WESLEY S F, FERGUSON D. Autoimmune encephalitides and rapidly progressive dementias[J]. Semin Neurol, 2019, 39(2):283-292. doi: 10.1055/s-0039-1678583
[8]	任海涛, 崔丽英, 关鸿志, 等.不明病因脑炎中抗N-甲基-D-天冬氨酸受体脑炎的筛查诊断[J].中华神经科杂志, 2014, 47(2):119-122.
[9]	BROADLEY J, SENEVIRATNE U, BEECH P, et al. Prognosticating autoimmune encephalitis:a systematic review[J]. J Autoimmun, 2019, 96:24-34. doi: 10.1016/j.jaut.2018.10.014
[10]	LEYPOLDT F, ARMANGUE T, DALMAU J. Autoimmune encephalopathies[J]. Ann N Y Acad Sci, 2015, 1338:94-114. doi: 10.1111/nyas.12553
[11]	LASCANO A M, VARGAS M I, LALIVE P H. Diagnostic tools for immune causes of encephalitis[J]. Clin Microbiol Infect, 2019, 25(4):431-436. doi: 10.1016/j.cmi.2018.12.012
[12]	林婧, 李悦, 卜碧涛.自身免疫性脑炎17例临床特点分析[J].神经损伤与功能重建, 2017, 12(3):212-214, 227. https://www.cnki.com.cn/Article/CJFDTOTAL-GWKF201703008.htm
[13]	GRAUS F, TITULAER M J, BALU R, et al. A clinical approach to diagnosis of autoimmune encephalitis[J]. Lancet Neurol, 2016, 15(4):391-404. doi: 10.1016/S1474-4422(15)00401-9
[14]	SHEN K, XU Y, GUAN H, et al. Paraneoplastic limbic encephalitis associated with lung cancer[J]. Sci Rep, 2018, 8(1):6792-6799. doi: 10.1038/s41598-018-25294-y
[15]	邵龙, 王威, 郑娜, 等.自身免疫性脑炎治疗进展[J].解放军医学杂志, 2017, 42(4):347-353. https://www.cnki.com.cn/Article/CJFDTOTAL-JFJY201704016.htm
[16]	NEWMAN M P, BLUM S, WONG R C W, et al. Autoimmune encephalitis[J]. Intern Med J, 2016, 46(2):148-157. doi: 10.1111/imj.12974
[17]	王佳伟, 刘磊.自身免疫性脑炎的热点问题及其面临的挑战[J].中华神经科杂志, 2016, 49(1):4-7.

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