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Limbic Encephalitis Associated with Anti-gamma-aminobutyric Acid B Receptor Antibodies: A Case Series from China

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收录情况: ◇ SCIE ◇ 统计源期刊 ◇ CSCD-C ◇ 中华系列

机构: [1]Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Neurol, Beijing 100730, Peoples R China; [2]Peking Union Med Coll, Beijing 100730, Peoples R China; [3]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing 100050, Peoples R China; [4]Capital Med Univ, Beijing Youanmen Hosp, Dept Neurol, Beijing 100054, Peoples R China; [5]Sichuan Univ, West China Hosp, Dept Neurol, Chengdu 610041, Sichuan, Peoples R China; [6]Chinese Acad Med Sci, Ctr Neurosci, Beijing 100730, Peoples R China
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关键词: Anti-gamma-aminobutyric Acid B Receptor Antibody Autoimmune Limbic Encephalitis Seizure

摘要:
Background: Autoimmune encephalitis associated with antibodies against gamma-aminobutyric acid B receptor (GABA(B)R) in patients with limbic encephalitis (LE) was first described in 2010. We present a series of Han Chinese patients for further clinical refinement. Methods: Serum and cerebrospinal fluid (CSF) samples from patients referred to the program of encephalitis and paraneoplastic syndrome of Peking Union Medical College Hospital were tested with indirect immunofluorescence. Clinical information of patients with anti-GABA(B)R antibody positivity was retrospectively reviewed, and descriptive statistical analysis was performed. Results: All eighteen anti-GABA(B)R antibody-positive cases had limbic syndromes, and electroencephalogram (EEG) or neuroimaging evidence fulfilled the diagnostic criteria of LE. Four patients had additional antibodies against Hu in serum and one had anti-N-methyl-d-aspartate receptor antibody in both sera and CSF. Seventeen (17/18) patients presented with new-onset refractory seizure or status epileptics. Twelve (12/18) patients had memory deficits, 11 (11/18) patients had personality change, 7 (7/18) patients had disturbance of consciousness, and 3 (3/18) patients showed cerebellar dysfunction. One patient with LE had progressive motor and sensory polyneuropathy. Lung cancer was detected in 6 (6/18) patients. Ten (10/18) patients showed abnormality in bilateral or unilateral mediotemporal region on magnetic resonance imaging. Ten (10/18) patients had temporal lobe epileptic activity with or without general slowing on EEG. Seventeen patients received immunotherapy and 15 of them showed neurological improvement. Four patients with lung cancer died within 1-12 months due to neoplastic complications. Conclusions: Our study demonstrates that most Han Chinese patients with anti-GABA(B)R antibody-associated LE have prominent refractory epilepsy and show neurological improvement on immunotherapy. Patients with underlying lung tumor have a relatively poor prognosis. Testing for anti-GABA(B)R antibodies is necessary for patients with possible LE or new-onset epilepsy with unknown etiology.

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出版当年[2014]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科
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出版当年[2013]版:
Q3 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q1 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2013版] 出版当年五年平均 出版前一年[2012版] 出版后一年[2014版]

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第一作者机构: [1]Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Neurol, Beijing 100730, Peoples R China; [2]Peking Union Med Coll, Beijing 100730, Peoples R China;
通讯作者:
通讯机构: [1]Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Neurol, Beijing 100730, Peoples R China; [2]Peking Union Med Coll, Beijing 100730, Peoples R China; [6]Chinese Acad Med Sci, Ctr Neurosci, Beijing 100730, Peoples R China
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