RÉSUMÉ
@#Objective To investigate the clinical manifestations, imaging features, treatment, and prognosis of autoimmune encephalitis （AE） with positive leucine-rich glioma-inactivated 1 （LGI1） antibody. Methods A retrospective analysis was performed for the clinical data of 11 patients with LGI1 antibody-positive AE who were admitted to Department of Neurology, The Sixth Medical Center of PLA General Hospital, from 2018 to 2022. Results Among these 11 patients, there were 10 patients with epilepsy, 8 patients with cognitive impairment, 6 patients with mental and behavioral disorders, 5 patients with sleep disorders, 1 patient with speech and language impairment, 1 patient with involuntary limb movements, 1 patient with dizziness, and 7 patients with hyponatremia. All 11 patients tested positive for LGI1 antibody, and 8 patients tested positive in serum and cerebrospinal fluid; 1 patient was also positive for contactin-associated protein-like 2 antibody, and 3 patients were positive for a single antibody in serum. Lung CT showed that 1 patient had space-occupying lesion, cranial magnetic resonance imaging showed abnormalities in 6 patients, and positron emission tomography/computed tomography showed abnormalities in 3 patients. There were 7 patients with electroencephalographic abnormalities. All 11 patients had improvements in symptoms after immunotherapy. Five patients were followed up, and 6 were lost to follow-up. Conclusion The main manifestations of LGI antibody encephalitis include seizure, faciobrachial dystonic seizures, cognitive impairment, and mental and behavioral disorders accompanied by hyponatremia. The titer of LGI1 antibody in serum is more sensitive than that in cerebrospinal fluid, and a few patients may have multiple positive autoantibodies. Immunotherapy is an effective treatment method for LGI1 antibody-positive AE.
RÉSUMÉ
To report a typical case of Morvan syndrome with positive anti-leucine rich glioma-inactivated 1(LGI1) and contactin-associated protein 2 (CASPR2) antibodies in serum and cerebrospinal fluid. A 39-years-old female initially presented weakness of extremeties. The main symptoms included paroxysmal limb pain, wheezing, itching, muscle twitching, epilepsy, hypomnesia, dysphoria, apathy, intractable insomnia, salivation and sweating. Tests of electrolytes found hypokalemia (2.7-3.1 mmol/L) and hyponatremia (130-136 mmol/L). Arterial blood gas analysis showed hypoxemia (oxygen saturation 50%-70%). Total thyroxine (TT4) was elevated to 207 nmol/L with positive thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab). LGI1and CASPR2 antibodies (CBA method) were positive in both serum and cerebrospinal fluid, and the remaining antibodies related to autoimmune encephalitis and paraneoplastic syndrome were negative. Head MRI was almost normal, while mild abnormalities were found in electroencephalogram. Electromyography showed slightly increased voltage of left quadriceps motor unit potential. After treated with corticosteroids, IVIG and mycophenolate mofetil, the patient completely improved. Cognitive function scores recovered from MoCA/MMSE (16/24) to MoCA/MMSE (26/29). Positivity of LGI1/CASPR2 antibodies both in serum/cerebrospinal fluid are rarely seen in patients with Morvan syndrome. Steroids and immunosuppressants are suggested for treatment as early as possible.
RÉSUMÉ
Objective To evaluate the efficacy and safety of solifenacin in patients with overactive bladder (OAB). Methods A multicenter clinical trial was conduced. 216 patients with OAB were enrolled. All the patients received solifenacin(5 mg once daily). With 5 weeks'treatment, all the patients recorded the diary and the adverse events as well. The symptoms of urgency, frequency, nocturia, urine volume, incontinence were evaluated. The results of the efficacy and safety were analyzed by using SPSS 13. 0. Results After 5 week treatments, all the index obviously improved(P<0.05). 187 cases (86.7%)were cured and 43 cases recovered normal voiding, 29 cases improved obviously. 11cases(5.0 %)reported adverse effect as dry mouth, dry eye. Conclusion Solifenacin could be the safe and effective drug in the treatment of OAB patients.