摘要
儿童抗N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor,NMDAR)脑炎是一种自身免疫性脑炎,其精神症状与年龄相关,发生率随年龄增长而增加。激越和紧张症是突出的症状。针对儿童的激越症状,首选药物治疗,当药物治疗无效时可考虑身体约束,有效的激越治疗不仅可以控制症状,还有助于患者依从免疫治疗。精神运动性激越是紧张症的核心症状,但对于儿童紧张症的临床认识仍有待深入,治疗方面也缺乏统一意见。电休克疗法已被证实是一种有效的治疗手段。<12岁儿童相较于青少年和成人,适应性功能易受损,可能会留下部分精神症状。因此,总结儿童抗NMDAR脑炎的精神症状、临床管理及预后有助于抗NMDAR脑炎的早期识别,规范对患儿精神行为症状的长程管理,从而改善预后。
Pediatric anti N-methyl-D-aspartate receptor(NMDAR)encephalitis is an autoimmune encephalitis.Its psychiatric symptoms are age-related,with the incidence increasing as the child grows older.Agitation and catatonia are prominent characteristic symptoms.For the treatment of agitation symptoms in children,medication is the preferred option.When medication proves ineffective,physical restraint can be considered.Effective management of agitation not only helps control symptoms but also motivates patients to comply with immunotherapy.Psychomotor agitation is a core symptom of catatonia,but our clinical understanding of catatonia in children is still limited,and there is a lack of consensus on treatment approaches.Electroconvulsive therapy has been proven to be an effective treatment modality.Children under 12 years may experience impaired adaptive functioning compared to adolescents and adults,which could lead to residual psychiatric symptoms.Therefore,summarizing the psychiatric symptoms,clinical management and prognosis of pediatric anti NMDAR encephalitis can improve early recognition of the condition and standardize the long-term management of psychiatric symptoms in affected children,thus enhancing prognosis.
作者
柳培娇(综述)
程敏
胡越(审校)
Liu Peijiao;Cheng Min;Hu Yue(Department of Neurology,Children′s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400010,China)
出处
《国际儿科学杂志》
2023年第12期800-804,共5页
International Journal of Pediatrics
作者简介
通信作者:胡越,Email:hyue915@163.com。
