原理:抗N-甲基-d-天冬氨酸受体(NMDAR)脑炎是一种自身免疫性突触性脑炎,通常由神经元表面抗体介导。临床上,它表现为各种各样的神经和精神症状,主要影响患有卵巢畸胎瘤的年轻女性,这在孕妇中很少见。患者的担忧:我们报告了一例35岁的多胎妊娠患者在妊娠38周时因癫痫发作而被送往急诊室,精神症状,如神志不清的言语和神秘的视觉和听觉幻觉,Bradylalia,逆行性健忘症.诊断:结合腰椎穿刺结果,判断自身免疫性脑炎的诊断为抗NMDA抗体。脑成像,和病人的持续症状。结果:这种情况因其罕见性和症状的广泛性而值得注意。妊娠38周时,病人做了剖腹产,在6个月的随访中观察到良好的产妇恢复和良好的新生儿适应。教训:我们的目标包括提高对这种情况的认识,并强调早期诊断的重要性。这种脑炎是可以治疗的,并且可能是可逆的,强调及时识别的重要性。
Rationale: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a form of autoimmune synaptic encephalitis, often mediated by neuronal surface antibodies. Clinically, it manifests through a diverse range of neurological and psychiatric symptoms, primarily affecting young women with ovarian teratoma, which is rare in pregnant women. Patient concerns: We report a case of a 35-year-old multiparous pregnant patient at 38 weeks of gestation presented to the emergency room with seizure, psychiatric symptoms like delirious speech with mystical visual and auditory hallucinations, bradylalia, and retrograde amnesia. Diagnosis: The diagnosis of autoimmune encephalitis with anti-NMDA antibodies was concluded by considering the lumbar puncture results, brain imaging, and the patient\'s persistent symptoms. Outcomes: This case is noteworthy for its rarity and the symptoms\' breadth. At 38 weeks of gestation, the patient underwent a cesarean section, resulting in excellent maternal recovery observed during the 6-month follow-up and good neonatal adaptation. Lessons: Our goals include raising awareness about this condition and emphasizing the significance of early diagnosis. This encephalitis is treatable and potentially reversible, underscoring the importance of prompt identification.