Anti-GABAB receptor encephalitis: clinical analysis of 5 cases

Abstract

Objective To investigate the clinical manifestation, auxiliary examination characteristics, therapeutic intervention and prognosis of anti-GABAB receptor encephalitis. Methods Clinical data of 5 patients diagnosed as anti-GABAB receptor encephalitis in Neurology Department of Zhengzhou University People′s Hospital were retrospectively analyzed. Results The initial symptom was seizures in all of the 5 patients with anti-GABAB receptor encephalitis. During the course of disease, mental and behavior disorders were found in 4 patients, cognitive disorder in 3 patients, autonomic dysfunction in 1 patient, central hypoventilation and parasomnia in 1 patient. Brain MRI showed limbic system lesions in 3 patients. Cerebrospinal fluid (CSF) test indicated lymphocytosis in three patients. The anti-GABABR antibody was positive in both serum and CSF in all patients. Chest CT showed lung occupying lesions in 4 patients, of which 2 lesions were diagnosed as small cell lung cancer by pathological examination. All patients received immunotherapy after being diagnosed as anti-GABAB receptor encephalitis and responded well to immunotherapy. 1 patient without tumor fully recovered during the follow-up, while residual lesions were left in the other 4 patients with tumors. Conclusions Anti-GABAB receptor encephalitis responds well to immunotherapy, and the early identification, diagnosis and treatment are very important to improve the prognosis of patients. Key words: Gamma-aminobutyric acid; Encephalitis; Epilepsy