免疫效应细胞相关神经毒性综合征 (ICANS) 患者的脑电图
Sarah Flanagan Wesley1, Alec R Friedman1, Christian Gordillo2
1Department of Neurology, Neuroimmunology Division, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America.
Journal of the neurological sciences
|July 31, 2025
概括
在CAR-T疗法中,在免疫效应细胞相关神经毒性综合征 (ICANS) 期间进行持续的EEG监测显示频繁的扩散减速和三相波,但很少出现临床发作. 长时间的EEG可能在排除电图发作后具有有限的效用.
科学领域:
- 神经科学是一个神经科学.
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫效应细胞相关神经毒性综合征 (ICANS) 是仿真抗原受体T细胞 (CAR-T) 治疗的严重并发症.
- 是ICANS的一个公认但不常见的表现.
研究的目的:
- 在CAR-T治疗后经历ICANS的患者中,以表征连续电脑电图 (EEG) 图案.
- 为了将EEG发现与临床发作活动和患者结果相关联.
主要方法:
- 从2018-2023年对ICANS后CAR-T患者的临床和连续EEG数据的回顾性分析.
- 评估基线认知状态,MRI发现,瘤参与以及感染/代谢参数.
主要成果:
- 29名患者符合纳入标准;较高的ICANS等级与EEG监测相关.
- 在36次连续EEG中没有检测到电图,尽管临床很少发生,但与死亡率增加有关.
- 扩散减速 (97.2%) 和焦点减速 (19.4%) 是常见的;非性三相形态发生在41.7%的患者中.
结论:
- 在ICANS中,临床发作很少见,并且与较高的死亡率有关.
- 连续的EEG可能对检测持续的型活动具有有限的实用性,一旦排除了电图发作.
- 三相波在ICANS中很常见,并不排除它是脑病变的原因.
更多相关视频
相关概念视频
Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...


