| Abstract |
Analysis of cognitive and mental disorders related to autoimmune encephalitis[Abstract] Objective To analyze the cognitive and mental disorders and treatment of patients with autoimmune encephalitis (AE). Methods Retrospective analysis of clinical data of 30 patients, including antibody type, clinical symptoms, MMSE diagnosis, treatment outcome, follow-up recurrence rate, etc. Results The anti-cell surface antigen antibody detection structure of 30 patients showed the highest positive rate of anti-NMDA antibody, reaching 90% (27/30). The three major clinical manifestations of mental disorders, cognitive dysfunction, and seizures only 3 (10%) patients showed a single performance, 22 (73.33%) had 2 manifestations, and 5 (16.67%) had 3 manifestations. Among the 30 patients, 23 patients (76.67%) had significant cognitive impairment and 18 patients (60%) were diagnosed by MMSE. The difference was not statistically significant (2=1.926, P=0.165). All patients were well discharged, and the anti-NMDA antibody patients were better treated. Patient cognitive impairment has improved significantly. Among them, those with epilepsy in the clinical symptom have left epilepsy, and the frequency of seizures was about 1 to 2 times/month. Epilepsy was present in patients with anti-LG1 antibody and anti-CASPR2 antibody, and the frequency of seizures after treatment was about 4 times/month. 18 patients with significant cognitive impairment had residual cognitive decline of different level after treatment. A total of 8 patients relapsed during the follow-up period, and the recurrence rate was 26.67% (8/30). The recurrence rate of elderly patients was 60% (3/5), 50% (2/4) for underage patients, and 14.29% (3/21) for young and middle-aged patients. The recurrence rate of young and middle-aged patients was significantly higher than that of elderly patients (continuous correction 2= 4.754, P=0.029) and underage patients (Fishers exact test P=0.035). Conclusion AE patients mainly present with mental behavior abnormalities, epilepsy and cognitive impairment, combining specific clinical manifestations based on antibody testing are conducive to early diagnosis, creating positive conditions for early treatment of patients, and the immunotherapy regimen worked well in anti-NMDA antipositive patients.
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