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Associations between seizures and MRI in patients with anti-NMDAR encephalitis.

抗 NMDAR 脑炎患者癫痫发作与 MRI 的相关性。

  • 影响因子:2.61
  • DOI:10.1111/ane.13298
  • 作者列表:"Ni G","Lin W","Cai X","Qin J","Feng L","Zhu S","Zhou L","Chen Z
  • 发表时间:2020-06-13
Abstract

OBJECTIVES:Seizures are a prominent feature of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Nearly half of brain magnetic resonance image (MRI) results are abnormal. The aim of our study was to evaluate the associations between seizures and brain MRI results in patients with anti-NMDAR encephalitis. METHODS:Patients with anti-NMDAR encephalitis were enrolled between January 2015 and December 2018. The patients included were divided into normal and abnormal MRI groups. Seizure outcomes and modified Rankin scale scores at the 1-year follow-up were assessed. Seizure characteristics and outcomes were compared between groups. RESULTS:Of 35 patients with anti-NMDAR encephalitis, 28 patients (80%) had reported seizures in the acute phase. Patients with abnormal MRI findings more frequently had focal seizures than patients with normal MRI findings (72.7% vs 17.6%, P<0.01). The incidence of patients treated with 2 or more antiepileptic drugs was higher in the normal MRI group than in the abnormal MRI group (100% vs 45.4%, P<0.01). The onset-immunotherapy time was shorter in the abnormal MRI group than in the normal MRI group (P<0.05). There were no statistically significant differences in seizure outcomes between the normal and abnormal MRI groups (P>0.05). CONCLUSIONS:Focal seizures were most common in patients with abnormal MRI lesions. In the acute stage of the disease, the abnormal MRI group was more likely than the normal MRI group to achieve seizure control. Abnormal MRI findings did not affect the overall good prognosis of patients with anti-NMDAR encephalitis with seizures.

摘要

目的: 癫痫发作是抗 N-甲基-D-天冬氨酸受体 (NMDAR) 脑炎的一个显著特征。近一半的脑磁共振图像 (MRI) 结果异常。我们研究的目的是评估抗 NMDAR 脑炎患者癫痫发作与脑部 MRI 结果之间的相关性。 方法: 纳入 2015 年 1 月至 2018 年 12 月间的抗 NMDAR 脑炎患者。将纳入患者分为 MRI 正常组和异常组。评估 1 年随访时的癫痫发作结局和改良 Rankin 量表评分。比较组间癫痫发作特征和结局。 结果: 35 例抗 NMDAR 脑炎患者中,28 例 (80%) 在急性期报告癫痫发作。MRI 表现异常的患者比 MRI 表现正常的患者更容易出现局灶性癫痫发作 (72.7% vs 17.6%,P<0.01)。MRI 正常组使用 2 种及以上抗癫痫药物的发生率高于 MRI 异常组 (100% vs 45.4%,P<0.01)。MRI 异常组发病-免疫治疗时间短于 MRI 正常组 (P<0.05)。MRI 正常组与异常组的发作结局差异无统计学意义 (P>0.05)。 结论: 局灶性癫痫发作在 MRI 异常病变患者中最常见。在疾病的急性期,异常 MRI 组比正常 MRI 组更容易达到癫痫控制。异常的 MRI 表现不影响伴有癫痫发作的抗 NMDAR 脑炎患者的总体良好预后。

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影响因子:1.52
发表时间:2020-01-27
来源期刊:World neurosurgery
DOI:10.1016/j.wneu.2020.01.108
作者列表:["Middlebrooks EH","Lin C","Okromelidze L","Lu CQ","Tatum WO","Wharen RE Jr","Grewal SS"]

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