Clinical And Electroencephalogram Analysis Of 36 Patients With Neuronal Surface Antibody-positive Encephalitis

Objective Through the analysis of the clinical manifestations,electroencephalogram characteristics and their correlation with the condition of 36 cases of neuronal surface antibody-positive encephalitis,the clinicians’understanding of this disease was improved,and the clinical basis for the diagnosis and treatment of neuronal surface antibody-positive encephalitis was provided.Methods The clinical data of patients with neuronal surface antibody-positive encephalitis diagnosed in General Hospital of Ningxia Medical University and Cardiovascular and Cerebrovascular Disease Hospital from October 2015 to December 2020 were collected.The general situation,clinical manifestations,laboratory examination,imaging and electroencephalogram characteristics,treatment and prognosis were analyzed.The correlation between electroencephalogram classification and clinical condition in acute phase was analyzed.Results 1.Among 36 patients with neuronal surface antibody-positive encephalitis,21cases(58.3%)were anti-NMDAR encephalitis,10 cases(27.8%)were anti-LGI1 antibody encephalitis,and 5 cases(13.9%)were anti-GABA_BR encephalitis.2.The common clinical manifestations of 36 patients were seizures 75.0%(27/36),mental behavior abnormalities 61.1%(22/36),and cognitive dysfunction 58.3%(21/36).The three groups of anti-NMDAR encephalitis,anti-LGI1 antibody encephalitis,and anti-GABA_BR encephalitis had statistical differences between the three groups in cognitive dysfunction,involuntary movement,and disturbance of consciousness(P<0.05).3.Among the 36 patients,22(61.1%)had imaging abnormalities,in which anti-NMDAR encephalitis often occurred in the parietal-occipital lobe,temporal lobe and frontal lobe,and a few involved the cerebellum,basal ganglia and brainstem.Anti-LGI1 antibody encephalitis and anti-GABA_BR encephalitis were mainly involved in the hippocampus,medial temporal lobe,insular lobe and amygdala.4.In this study,36 patients with electroencephalogram abnormalities in 26 cases(72.2%),22 patients with electroencephalogram showed varying degrees of slow wave changes,8 cases were accompanied by epileptic waves,4 cases showed simple epileptic waves,1 case of anti NMDAR encephalitis found specific extremeδbrush.5.In this group of data,10 patients with normal electroencephalogram in the acute phase were all in the mild disease group,and no patients in the severe group;and 8 patients with severe electroencephalogram abnormalities were all in the severe group,and none in the mild group.The degree of abnormal electroencephalogram in the acute phase is positively correlated with the severity of the clinical condition(r=0.696,P<0.001).6.Among the 36 patients in this group,80.6%(29/36)of the patients basically recovered after treatment,of which 10(27.8%)left mild cognitive impairment,mainly manifested as near memory loss and personality change.Conclusion1.The common clinical manifestations of neuronal surface antibody-positive encephalitis are epileptic seizures,mental behavior abnormalities,and cognitive dysfunction in order.Anti-NMDAR encephalitis is more prone to involuntary movement,and anti-LGI1 antibody encephalitis is more prone to cognitive dysfunction.2.Neuronal surface antibody-positive encephalitis electroencephalogram mainly manifests as non-specific slow wave changes,which may have epileptic waves;and the more serious the clinical condition,the more obvious the abnormality of the electroencephalogram,which can be used as a judgment index of the severity of clinical conditions in such patients.3.Neuronal surface antibody-positive encephalitis immunotherapy is effective,mostly good prognosis.