MỘT SỐ ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG VIÊM NÃO TỰ MIỄN DO KHÁNG THỂ KHÁNG THỤ THỂ N-METHYL-D-ASPARTATE

Abstract

Objective: Determine the clinical and subclinical characteristics Anti-NMDA receptor encephalitis.  Subjects: We selected 35 patients  were diagnosed Anti-NMDA receptor encephalitis at Bach Mai Hospital during January 2020 to October 2022. Methods: Cross-sectional descriptive study. Results: Thirty-five NMDA encephalitis patients studied, the mean age of the patients was 30.6 ± 13.7, with a female predominance (62.9%). Psychiatric symptoms appeared in the majority of patients (94.3%). Neurological symptoms such as consciousness disturbances, seizures, dyskinesias and movement disorders, sleep disturbances were also common with the corresponding rate of 82.9%, 57.1%, 54.3%, 57.1%; Autonomic dysfunction is uncommon with the rate of 22.8%. Cerebrospinal fluid abnormalities were mainly leukocytosis (77.1%) in which the slight increase in cell count from 5 -50 cells/mm3 accounts for 67.7%. Increased protein in the cerebrospinal fluid was uncommon, accounting for 8.5% (3 patients). The results of cranial MRI didn’t detect any abnormalities in the majority of patients (82.9%). The proportion of patients with abnormality on EEG accounts for 74.3%, of which mainly delta brush image accounts for 58.3%, diffuse slow wave is 31.4%, sharp waveform epilepsy is less common, accounting for 11.4%. There were 31 patients with no tumor detected, accounting for 88.6%, 4 patients (11.4%) had tumors, of which all 4 patients were female and were ovarian teratomas. Conclusion: In summary, through the study of clinical and subclinical of NMDA encephalitis, we found that NMDA encephalitis is a common autoimmune encephalitis in young women, with the predominant clinical symptom being psychiatric disorders and in some cases associated with ovarian teratomas. In terms of subclinical, Although cranial MRI usually does not detect abnormalities, increased white blood cells in the cerebrospinal fluid and electroencephalogram abnormalities may suggest an early diagnosis for the patient, especially the delta brush wave on the electroencephalogram.