ABSTRACT
Objective To investigate the clinical characteristics and prognosis of anti-N-methyl-D-aspartate receptor ( NMDAR) encephalitis .Methods The clinical data of 23 anti-NMDAR encephalitis patients , including 9 cases of severe patients were retrospectively analyzed .Results There were 9 cases of severe patients ( including 2 males and 7 females ) admitted to ICU for the treatment , and 14 patients ( including 3 males and 11 females ) admitted to the neurology department for the treatment .The age of the patients was (32.6 ±14.6) years , the course of disease was (26.7 ±36.9) d, and the length of stay was (34.2 ±27.5) days.In critically ill patients, the average length of stay was (22.2 ±13.7) d.The main clinical manifestations included 21 patients with mental and behavioral abnormalities , 13 patients with fever , 19 patients with epilepsy , 15 patients with conscious disturbance , 2 patients with motor dysfunction , 13 patients with dysautonomia , and 5 patients with hypoventilation . There was 1 case of patients with teratoma .The anti-NMDAR antibodies of CFS were positive in all patients , of which 18 cases of serum anti-NMDAR antibody were positive .Five patients of head MRI showed the abnormal signal of the temporal lobe , hippocampus or frontal lobe .The EEG of 19 patients showed abnormal slow wave .23 patients received the glucocorticoid , the gamma globulin , the plasma exchange and other immunomodulatory treatment .Six patients were completely cured , and 17 patients were improved but with residual symptoms .Conclusions The patients with Anti-NMDAR encephalitis usually manifest such as the rapid changes in mental behavior , the epilepsy and other symptoms , as well as the disturbance of consciousness , the movement disorders , the autonomic dysfunction , but of which combined tumors are rare .The prognosis of patients with anti NMDAR encephalitis is better, who received positive immunotherapy .