Girls from the flowering season from headache to illness, Hunan Provincial Brain Hospital cuts "self -exempting encephalitis"

Text/Video Hunan Daily All Media Reporter Tan Yuxin

On August 19, the new progress of clinical neuromanology at Huashan Hospital affiliated to Fudan University's Affiliated to the Eighth Fudan University kicked off. As the director of the Department of Neurology, Hunan Provincial Hospital (Provincial Second People's Hospital), Professor Tuwen's team shared the case of autoimmune encephalitis. She said, "The autoimmune encephalitis was discovered by the academic community in 2007, and the public's understanding of it so far. We look forward to more Chinese voices in this emerging field, which benefit more patients."

Automotic encephalitis refers to a category: encephalitis mediated by autoimmune mechanism, including anti-NMDA receptor encephalitis, marginal encephalitis, and other syndrome. %. Among the encephalitis with unknown etiology, the incidence of auto -immune encephalitis in young patients is higher than that of viral encephalitis.

On June 19, Chen Hong (pseudonym), a 17 -year -old college student, felt a little headache. She has always been healthy, thinking that she was cold and didn't care too much. At noon three days later, Chen Hong suddenly lost consciousness, his limbs twitched, and his mouth spit out foam. After discovering, her parents quickly took her to the hospital for nuclear magnetic resonance. During the waiting results, anxious parents found local Chinese medicine prescribed medicine. However, Chen Hong's symptoms were not eased and hallucinated.

After many twists and turns, the family members brought Chen Hong to Hunan Provincial Brain Hospital Epilepsy Specialty. On July 5th, Professor Tu Ewen, director of the Department of Internal Affairs of Epilepsy. In the anxious waiting of the patient's family, Professor Tu couldn't take care of lunch and immediately rushed over. She found that Chen Hong's situation was very bad, the convulsions frequently occurred, did not know their loved ones, were unclear, and danced. Combined with the patient's condition and treatment, Professor Tu initially judged that he was "autoimmune encephalitis". In view of the rapid progress of the condition, it is recommended to transfer patients to the intensive care unit as soon as possible.

The results of the inspection that night confirmed the judgment of Professor Tu, and Chen Hong's diagnosis was clearly anti -NMDAR encephalitis. In response to it, the intensive care unit immediately enabled plasma replacement and combined hormone impact treatment. At noon on July 9, Professor Tu received a call from Dr. ICU in the middle of the meeting. Patients showed that the cliff pressure was greater than 400mmH2O during the review of lumbar spine, which was risk of cerebral hernia. Reviewing the head of the skull, it really found multiple new lesions in the patient's intracranial, and the brain swelling was obvious.

Faced with the anxious Chen Hong's parents, Professor Tu comforted: "Don't worry, these are all expected, we will do our best." As soon as the meeting ended at more than 5 pm, she immediately took a taxi over 30 kilometers and rushed back to return. Hospital, look at the image change, adjust the treatment plan.

The combination of plasma replacement, hormone shock and intravenous injection of immunoglobulin. On July 19, Chen Hong's condition improved and transferred to the general ward. After two reviews, the titer of the blood and cerebrospinal fluid antibody of the flower season tended to be normal. Dis -hospital was discharged on August 3, and it was just a beginning to catch up with September.

Chen Hong is lucky, but not all patients with self -immune encephalitis are so lucky. It is reported that the treatment cycle of the average intensive treatment ward of intensive anti-NMDAR encephalitis is 1-2 months, and the mortality rate of the disease is 2.9%-9.5%. The complete recovery of a few patients is more than 2 years.

The advanced symptoms of autoimmune encephalitis make it easily confused with other diseases, and they are misjudged as viral encephalitis and mental illness. Professor Tu reminded that the autoimmune encephalitis may have symptoms such as headache and fever before the onset of onset. Within a few days or weeks, there will be mental behavior abnormalities, seizures, recent memory disorders, speech disorders, dysfunction, autonomous nerve dysfunction, and abnormal sleep. In severe cases, conscious disorders and coma. However, as long as you have sufficient understanding of autoimmune encephalitis and seek medical treatment in time, about 80%of patients with anti -NMDAR encephalitis have a good function, and patients have a better prognosis of patients with immunotherapy and non -severe patients early.

[Responsible editor: Wang Yaobing Intern: Yang Shuwen]

[Source: Hunan Daily · New Hunan Client]

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