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中华脑血管病杂志(电子版) ›› 2025, Vol. 19 ›› Issue (04) : 347 -351. doi: 10.3877/cma.j.issn.1673-9248.2025.04.013

病例报告

以发作性头晕为首发临床表现的自身免疫性脑炎病例分析及文献回顾
谭霞, 陈仁智()   
  1. 417000 湖南 娄底,娄底市第一人民医院神经内科
  • 收稿日期:2024-10-24 出版日期:2025-08-01
  • 通信作者: 陈仁智

Autoimmune encephalitis presenting with paroxysmal dizziness as the initial clinical manifestation: a case analysis and literature review

Xia Tan, Renzhi Chen()   

  • Received:2024-10-24 Published:2025-08-01
  • Corresponding author: Renzhi Chen
引用本文:

谭霞, 陈仁智. 以发作性头晕为首发临床表现的自身免疫性脑炎病例分析及文献回顾[J/OL]. 中华脑血管病杂志(电子版), 2025, 19(04): 347-351.

Xia Tan, Renzhi Chen. Autoimmune encephalitis presenting with paroxysmal dizziness as the initial clinical manifestation: a case analysis and literature review[J/OL]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2025, 19(04): 347-351.

图1 2024年5月13日患者头部MRI成像图。图a为T1弥散成像未见异常;图b为液体抑制反转恢复序列提示左侧额中回皮质少许高信号,意义待定;图c为弥散加权成像未见异常;图d为磁共振血管成像提示双侧椎动脉V4段可疑病变
表1 自身免疫性脑炎抗体20项检测结果
项目 检测方法 结果 参考区间
抗谷氨酸受体(NMDA)抗体 CBA法 阴性(-) 阴性(-)
抗谷氨酸受体(AMPA1)抗体 CBA法 阴性(-) 阴性(-)
抗谷氨酸受体(AMPA2)抗体 CBA法 阴性(-) 阴性(-)
抗富亮氨酸胶质瘤失活蛋白1(LGI 1)抗体 CBA法 阴性(-) 阴性(-)
抗接触蛋白关联蛋白2(CASPR2)抗体 CBA法 阴性(-) 阴性(-)
抗γ-氨基丁酸B型受体(GABAB)抗体 CBA法 阴性(-) 阴性(-)
抗IgLON家族蛋白5(IgLON5)抗体 CBA法 阴性(-) 阴性(-)
抗二缩氨酸相似蛋白6(DPPX)抗体 CBA法 阴性(-) 阴性(-)
抗甘氨酸受体1(GlyR1)抗体 CBA法 阴性(-) 阴性(-)
抗多巴胺受体2(DRD2)抗体 CBA法 阴性(-) 阴性(-)
抗谷氨酸脱羧酶65(GAD65)抗体 CBA法 阴性(-) 阴性(-)
抗代谢性谷氨酸受体5(mGluR5)抗体 CBA法 阴性(-) 阴性(-)
抗代谢型谷氨酸受体1(mGluR1)抗体 CBA法 阴性(-) 阴性(-)
抗突触蛋白-3a(Neurexin-3a)抗体 CBA法 阴性(-) 阴性(-)
抗γ-氨基丁酸A型受体(GABAA)抗体 CBA法 阴性(-) 阴性(-)
抗Kelch样蛋白11(KLHL11)抗体 CBA法 阴性(-) 阴性(-)
抗神经节乙酰胆碱受体(ganglionic AChR)抗体 CBA法 阴性(-) 阴性(-)
抗水通道蛋白4抗体(AQP4) CBA法 阴性(-) 阴性(-)
抗髓鞘少突胶质细胞糖蛋白(MOG)抗体 CBA法 阴性(-) 阴性(-)
抗胶质纤维酸性蛋白(GFAP)抗体 CBA法 阴性(-) 阴性(-)
图2 2024年5月24日患者脑电图检查提示左侧前额前区高幅尖波散发
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