Clinical analysis of 14 patients with anti-metabotropic glutamate receptor 5 encephalitis / 中华神经医学杂志

ABSTRACT

Objective:To summarize the clinical and imaging characteristics of anti-metabotropic glutamate receptor 5 (mGluR5) encephalitis, and improve clinicians' understanding of this encephalitis.Methods:The clinical data of one patient with anti-mGluR5 encephalitis admitted to our hospital from December 2020 were analyzed, and the data of 13 patients with anti-mGluR5 encephalitis reported in domestic and foreign databases were summarized and analyzed.Results:The main symptoms of 14 patients with anti-mGluR5 encephalitis included mental and behavior disorder (13/14), cognitive dysfunction (11/14), sleep dysfunction (9/14), seizures (8/14), decreased level of consciousness (6/14) and motor disorders (4/14). Four patients had abnormal brain MRI, including hyperintensity in the right mesial temporal lobe on T2 sequences, hyperintensity in the bilateral upper pons on T2 sequences, hyperintensity in the bilateral posterior parietal-occipital cortex on FLAIR sequences, and hyperintensity in the bilateral frontal lobes, right occipital lobe and cerebellum on T2/FLAIR sequences. Six patients had Hodgkin's lymphoma. Treatments included immunotherapy and oncologic therapy. Relapse was noted in 3 of the 14 patients, and symptoms improved significantly after immunotherapy. Except for one patient who died in hospital, 6 patients showed complete recovery and 7 patients showed partial recovery at the last follow-up (median 20 months).Conclusions:Anti-mGluR5 encephalitis is rare autoimmune encephalitis whose symptoms are not limited to the limbic system, and relapse may occur; immunotherapy has good effects; Hodgkin's lymphoma is often associated in these patients.