Clinical Analysis Of 9 Patients With Anti-N-methyl-D-aspartate Receptor Encephalitis

Objective To explore the clinical features of anti-NMDAR encephalitis and to provide reference for the clinical diagnosis and treatment of anti-NMDAR encephalitis.Methods The clinical data of patients with anti-NMDAR encephalitis treated in our hospital within two years was retrospectively analyzed.The clinical features and related test results were analyzed and summarized.Results There were 2 males and 7 females in 9 patients,the age of onset was 16-47 years old and the average age was 27.9±11.7 years old.Patients were presented with psychological symptoms(7 patients),seizures(7 patients),movement disorder(7 patients),autonomic nervous dysfunction(7 patients),cognitive impairment(6 patients),disturbance of consciousness(6 patients),speech impairment(5 patients).patients often started to get sick from seizures(3 patients),psychological symptoms(2 patients),speech impairment(2 patients).The disease was complicated with pulmonary infection(7 patients),liver damage(5 patients),hyponatremia(4 patients),respiratory failure(4 patients),urinary tract infection(4 patients),pulmonary embolism(2 patients),Hashimoto's thyroiditis(2 patients).Three patients had elevated tumor markers,one of which was ovarian teratoma.Seven patients had abnormal EEG,and five patients had abnormal MRI signal.Cerebrospinal fluid leukocytes increased in seven patients,which mainly based on lymphocyte reaction.Therapeutic efficiency was 67%,and compared poor efficacy group with treatment improved group,the leukocyte ratio and lymphocyte ratio in cerebrospinal fluid was increased.Conclusion Anti-NMDAR encephalitis is more common in young women,which presented with psychiatric symptoms,seizures,cognitive decline,motor abnormalities as the main clinical features.It should be identified with viral encephalitis.Higher proportion of CSF pleocytosis and lymphocytes may affect the prognosis of patients.