Autoimmune encephalitis in psychiatric institutions: current perspectives.
Autoimmune encephalitis in psychiatric institutions: current perspectives.
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DOI：
10.2147/ndt.s82380
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发表时间：
2016
影响因子：
3.2
通讯作者：
Honnorat J
中科院分区：
文献类型：
--
作者：
Bost C;Pascual O;Honnorat J
自身免疫性脑炎是一种罕见的新发现的疾病，涉及针对突触和神经元细胞表面抗原的自身抗体。它包括广泛的神经精神症状。敏感和特异性的诊断试验，如基于细胞的测定，是检测患者脑脊液或血清中神经元细胞表面抗体的基础，并确定患者的治疗和随访。由于神经系统症状在文献中有很好的描述，本综述的重点是在发病或疾病过程中出现的精神症状的性质。为了帮助诊断，详细介绍了最具代表性的突触和神经元细胞表面自身抗体的主要神经症状。最后，近十年来对这些自身抗体的探索使我们能够对精神疾病中自身免疫性脑炎的发病率和精神疾病表现管理的一般指南进行概述。对于大多数自身免疫性脑炎，预后取决于疾病的检测，识别和管理的速度。因为明显的精神症状会驱使患者去精神病院，并可能阻碍诊断，这项工作的目的是提供线索，帮助医生早期发现，从而为患者提供更好的医疗服务。
Autoimmune encephalitis is a rare and newly described group of diseases involving autoantibodies directed against synaptic and neuronal cell surface antigens. It comprises a wide range of neuropsychiatric symptoms. Sensitive and specific diagnostic tests such as cell-based assay are primordial for the detection of neuronal cell surface antibodies in patients’ cerebrospinal fluid or serum and determine the treatment and follow-up of the patients. As neurological symptoms are fairly well described in the literature, this review focuses on the nature of psychiatric symptoms occurring at the onset or during the course of the diseases. In order to help the diagnosis, the main neurological symptoms of the most representative synaptic and neuronal cell surface autoantibodies were detailed. Finally, the exploration of these autoantibodies for almost a decade allowed us to present an overview of autoimmune encephalitis incidence in psychiatric disease and the general guidelines for the management of psychiatric manifestations. For the majority of autoimmune encephalitis, the prognosis depends on the rapidity of the detection, identification, and the management of the disease. Because the presence of pronounced psychiatric symptoms drives patients to psychiatric institutions and can hinder the diagnosis, the aim of this work is to provide clues to help earlier detection by physicians and thus provide better medical care to patients.