兴奋姬蛙:抗 NMDAr 脑炎急性复发的临床生物标志物。

IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY
Lina Jeantin, Louis Cousyn, Vincent Navarro, Vi-Huong Nguyen Michel
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引用次数: 0

摘要

抗 NMDAr 脑炎患者的睡眠障碍包括失眠、嗜睡、嗜睡症和睡眠呼吸障碍。一名患者出现了抗NMDAr脑炎的典型特征,并伴有右侧卵巢畸胎瘤。经过两个月的免疫治疗,患者的临床症状有所改善,但病情恶化。24 小时视频脑电图-多导睡眠图显示,患者睡眠量严重不足,由短的 N1 簇和快速眼动睡眠阶段组成的睡眠结构被完全破坏,并伴有运动和自主神经活动亢进。这些特征与兴奋性粒细胞减少症一致,并与左侧卵巢畸胎瘤导致的疾病复发有关。新的免疫疗法和手术改善了临床症状,并使睡眠模式恢复正常。兴奋躁狂症是最严重的分离状态,是该患者疾病复发的睡眠生物标志物。目前还缺乏抗NMDAr脑炎急性期的多导睡眠图研究,因此需要对其进行研究,以更好地了解睡眠模式的演变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Agrypnia excitata: a clinical biomarker of acute relapse in anti-NMDAr encephalitis.

Sleep disorders have been described in anti-NMDAr encephalitis including insomnia, hypersomnia, narcolepsy, and sleep-disordered breathing. A patient presented with typical features of anti-NMDAr encephalitis associated with a right ovarian teratoma. After two months of clinical improvement with immunotherapy, the patient deteriorated. A 24-hour video EEG-polysomnography revealed a severe sleep quantity deficit, a total destruction of sleep architecture consisting of short clusters of N1 and rapid eye movement sleep stages, associated with motor and autonomic hyperactivity. These features were consistent with agrypnia excitata and were associated with disease reactivation due to a left ovarian teratoma. A new course of immunotherapy and surgery improved clinical symptoms and normalized sleep patterns. Agrypnia excitata, the most severe form of status dissociatus, was a sleep biomarker of disease relapse in this patient. Polysomnographic studies in the acute phase of anti-NMDAr encephalitis are lacking and are needed to better understand the evolution of sleep patterns.

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来源期刊
CiteScore
6.20
自引率
7.00%
发文量
321
审稿时长
1 months
期刊介绍: Journal of Clinical Sleep Medicine focuses on clinical sleep medicine. Its emphasis is publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the journal will publish proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine.
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