UNASSIGNED: A retrospective study was conducted on patients with anti-NMDAR encephalitis who were first diagnosed and treated in the First People\'s Hospital of Yunnan Province from January 2017 to September 2022. According to the presence or absence of MDs, all patients were divided into two groups, and the clinical manifestations, auxiliary examinations, and prognosis of the two groups were compared. Patients in the MDs group were further subgrouped by different ages (<12 years, 12-17 years, and ≥ 18 years) and genders, and the prevalence of each MD was compared in different age and gender groups.
UNASSIGNED: (1) In our study there were 64 patients, of whom 76.6% (49/64) presented with MDs; the median age of onset in patients with MDs was 21 (15,35) years and 65.3% (32/49) were female. The three most common MDs were orofacial dyskinesia (OFLD) (67.3%), dystonia (55.1%), and stereotypies (34.7%). Patients <12 years were more likely to experience chorea than patients in other age groups (p = 0.003). (2) Compared with the non-MDs group, patients in the MDs group showed higher rates of prodromal manifestations, autonomic dysfunction, consciousness disorders, as well as pulmonary infection and gastrointestinal dysfunction (all p < 0.05). Peripheral blood neutrophil to lymphocyte ratio (NLR) (p = 0.014), the proportion of cerebrospinal fluid (CSF) NMDAR antibody titers ≥1:32 (p = 0.047), ICU admission rate (p = 0.04), length of stay (p = 0.007), maximum mRS score in the course of disease (p = 0.001) and mRS score at discharge (p = 0.006) in the MDs group were significantly higher than the non-MDs group.
UNASSIGNED: MDs associated with anti-NMDAR encephalitis were predominantly hyperkinetic. Chorea occurred more commonly in patients aged <12 years. Patients with MDs were prone to autonomic dysfunction, consciousness disorders, pulmonary infection, and gastrointestinal dysfunction; they had more intense inflammation, more severe disease, and a poorer short-term prognosis.
■回顾性研究2017年1月至2022年9月在云南省第一人民医院首次诊治的抗NMDAR脑炎患者。根据MD的存在或不存在,将所有患者分为两组,和临床表现,辅助考试,比较两组患者的预后。MDs组的患者按不同年龄进一步分组(<12岁,12-17年,且≥18岁)和性别,并比较不同年龄和性别组的每种MD的患病率。
■(1)在我们的研究中有64名患者,其中76.6%(49/64)出现MDs;MDs患者的中位发病年龄为21岁(15,35岁),65.3%(32/49)为女性.三种最常见的MD是口面运动障碍(OFLD)(67.3%),肌张力障碍(55.1%),和陈规定型观念(34.7%)。<12岁的患者比其他年龄组的患者更有可能发生舞蹈病(p=0.003)。(2)与非MD组相比,MDs组的患者表现出更高的前驱症状,自主神经功能障碍,意识障碍,以及肺部感染和胃肠功能障碍(均p<0.05)。外周血中性粒细胞与淋巴细胞比率(NLR)(p=0.014),脑脊液(CSF)NMDAR抗体滴度≥1:32的比例(p=0.047),ICU入院率(p=0.04),停留时间(p=0.007),MDs组病程中的最大mRS评分(p=0.001)和出院时的mRS评分(p=0.006)显著高于非MDs组.
■与抗NMDAR脑炎相关的MD主要是运动过度。舞蹈症更常见于年龄<12岁的患者。患有MD的患者容易出现自主神经功能障碍,意识障碍,肺部感染,和胃肠功能紊乱;他们有更强烈的炎症,更严重的疾病,短期预后较差。