《自身免疫性脑炎》ppt课件模板.pptVIP

* * 根据症状的一些共同点，分为5期，不一定都表现为这5种期别，各期之间也没有明显的界限 70%患者具有前驱症状 癫痫一般是难治性癫痫，需要多种抗癫痫药物联合，甚至静脉滴注抗惊厥药物 * * 代谢梯度 * 血里和CSF里都可以测 NMDA抗体应以CSF抗体阳性为主要依据，如果仅有血清成低滴度阳性，则需要谨慎评价结果的诊断意义 * 伴有肿瘤并且在神经疾病出现的最初4个月内切除肿瘤者预后较好 * * 电压门控钾离子通道抗体 针对胞外的抗体才有致病性 细胞表面抗原 * FBDS：短暂性、同侧面部和上肢为著的肌张力障碍发作，通常持续数秒（5s），伴或不伴意识障碍，通常发作很频繁，平均50次/d * * FLAIR-hyperintense signal alterations in the hippocampus bilaterally (right left; A), with contrast enhancement on the right side (B). The patient presented with frequent faciobrachial dystonic seizures (FBDS), followed by confusion, agitation, and severe memory impairment. Following immunotherapy with IV steroids, plasma exchange and IV immunoglobulins FBDS ceased while memory impairment persisted. Follow-up MRI 17 months later showed bilateral (right left) atrophy of the hippocampus as well as moderate global atrophy (C). (D) FDG–PET showing bilateral hypermetabolism in the basal ganglia in a 92-year-old patient that presented with up to 100 FBDS/day but without cognitive deficits. FBDS stopped after two courses of IV immunoglobulin therapy. MRI was unremarkable except mild global atrophy and microangiopathic leukoencephalopathy and especially showed no abnormalities of basal ganglia or medial temporal lobes (Fidzinski et al., 2014). * Brain magnetic resonance imaging (MRI) andfluorodeoxyglucose positron emission tomography (FDG-PET)findings. T2-weighted orfluid attenuated inversion recovery MRI scans show high signals in the medial temporal lobes (A, B, E, F, I, J, M, N). F-18 FDG-PET images shows hypermetabolism in the medial temporal lobes (C, D, G, H,K, O, P) and basal ganglia (D, H, P). Images from patient 1 (A–D), patient 2 (E–H), patient 3 (I–L),patient9(M),andpatient4(N–P) are presented * On the evening of July 24, 2021 Courseware template