【摘要】 目的分析复发性抗富亮氨酸胶质瘤失活1蛋白(LGI1)脑炎的临床特点、诊断、治疗及预后情况。方法收集郑州大学第一附属医院2015-01—2019-01确诊抗LGI1脑炎患者,回顾性分析复发患者临床表现、实验室及影像检查、治疗及预后。结果 37例抗LGI1脑炎确诊患者中,13例复发,6例有多次复发。4例复发期出现新的症状,9例复发症状为首次发病症状的再次出现。认知功能下降、癫痫、精神症状及自主神经症状为复发患者首次发病和复发常见症状。13例复发患者有10例接受序惯口服激素治疗,第1次复发前口服激素平均时间为2.25个月。13例患者死亡6例。10例患者首次复发重启免疫治疗。预后良好(mRS≤2分)患者复发至重启免疫治疗平均时间2.6 d,预后差患者33.5 d。结论抗LGI1脑炎复发比较常见,患者复发症状多为首次发病症状的再次出现。及时重启免疫治疗的复发患者,预后良好。更多还原

【Abstract】 Objective To analyze clinical characteristics,ancillary tests,treatment and outcome in relapsing anti-LGI1 encephalitis.Methods Clinical characteristics,experimental tests,image examination,treatment and outcome of LGI1-antibody encephalitic patients from January 2015 to January 2019 were reviewed retrospectively.Results Thirteen patients relapsed among the 37 LGI1-antibody encephalitic patients,and six patients had multiple relapses.Four patients presented new symptoms in relapses,nine patients relapsed with reoccurrence of initial symptoms.Cognitive decline,seizure,neuropsychiatric symptom and autonomic disorder were the most common symptoms in acute phase and relapse.Ten patients received sequential corticosteroids treatment for mean time of 2.5 months before first relapse.Among the 13 relapsing patients,six patients died.10 patients relapsed and restarted immunotherapy for the first time.The mean time from first relapse to restarted immunotherapy was 2.6 days among patients with good outcome(mRS≤2) and 33.5 days with bad outcome.Conclusion Relapse is common in anti-LGI1 encephalitis.Most patients relapsed with reoccurrence or exacerbation of initial symptoms.Relapsing patients with prompt reinstitution of immunotherapy have comparably good outcome.更多还原