[学龄儿童自身免疫性脑炎的认知和精神病学的演变:临床案例]
Myriam Guadalupe Márquez-Zapata1, Gustavo Joaquín Cruz-Ruelas2, Alma Patricia González3
1Universidad de Guanajuato, Campus León, División Ciencias de Salud, Departamento de Medicina y Nutrición. León, Guanajuato, México.
Revista medica del Instituto Mexicano del Seguro Social
|March 3, 2026
概括
儿童自身免疫性脑炎 (AE) 可能伴有精神病症状. 早期诊断和免疫治疗对于儿童自身免疫脑炎病例的更好的结果至关重要.
科学领域:
- 儿科神经学 儿科神经学
- 神经免疫学 神经免疫学
- 儿童精神病学 儿童精神病学
背景情况:
- 自身免疫性脑炎 (AE) 是儿童罕见的疾病.
- AE可以表现为精神症状,往往在神经症状之前或掩盖神经症状.
- 早期诊断和治疗对于改善患者预后至关重要.
研究的目的:
- 在儿童中呈现自身免疫性脑炎的病例,并出现初始的精神和行为症状.
- 突出了儿科AE的诊断挑战和治疗方法.
- 为了说明AE治疗后的长期认知和行为结果.
主要方法:
- 一个10岁的女性病例报告,有3周的行为变化和神经缺陷病史.
- 诊断工作包括排除感染过程,脑MRI和EEG.
- 治疗包括免疫调节剂,塞特拉林和抗精神病药物.
主要成果:
- 患者出现了消抑制,情绪波动,感官不耐受和渐进的半.
- 大脑MRI显示了基底性脑膜炎;EEG是正常的.
- 免疫调节疗法导致逐渐改善,在3个月后出现残留认知障碍,15个月后完全认知恢复.
结论:
- 儿童自身免疫性脑炎的诊断需要高的怀疑指数,因为非特异性症状.
- 及时免疫治疗对于管理AE和改善长期结果至关重要.
- 虽然恢复是可能的,但有些患者可能会出现持续的症状,如易怒和感官敏感性.
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