MỘT SỐ ĐẶC ĐIỂM LÂM SÀNG Ở BỆNH NHÂN VIÊM NÃO TỰ MIỄN KHÁNG THỂ KHÁNG THỤ THỂ NMDA

Abstract

Objective: Describe some clinical features in NMDA (N-methyl-D-partate) encephalitis. Method: a Retrospective description of case series, data was collected on all patients diagnosed  with NMDA encephalitis who treated by plasma exchange during the period from January 2021 to June 2023 at the Intensive Care Center of Bach Mai Hospital. Results:  41 patients studied were inrolved in this study  in which male/female ratio was 1:2, mean age: 29.2±11.48; The most common symptom of NMDA encephalitis  was mental disorders (55%), followed by neurological disorders with 44%. In the patients has mental disorders, the most common symptom is agitation with 49.8% flowed by paranoias (31.7%) and less common sypmtoms were lethargy, inappropriate thinking and odd behavior. In the patients has neurological symptoms, convulsion is most symptoms with 34.1% , some comomon symptoms were consciousness (29.3%), dyskinesia (7.3%), problem of language (17.1%). Severe patients need to be transferred to intensive care for treatment, often due to neurological disorders that are difficult to control. All 41 patients was treated by PEX  which succes in 40 patients and the symptoms improved after 6 times. Conclusion: NMDA encephalitis is common in young women, with the predominant onset symptoms being mental disorders and the most common symptoms was agitation, in the group neurological disorders, convulsion is common sypmtom. However, the most common severe neurological symptoms that require treatment in intensive care are neurological symptoms with consciousness disorders and difficult-to-control seizures.