著者
飯塚 高浩
出版者
日本神経学会
雑誌
臨床神経学 (ISSN:0009918X)
巻号頁・発行日
vol.49, no.11, pp.774-778, 2009 (Released:2009-12-28)
参考文献数
10
被引用文献数
4 or 0

Recently a new category of treatment-responsive encephalitis has been proposed associated with antibodies against neuronal cell membrane antigens, including VGKC, NMDA receptor (NMDAR) and AMPA receptor. Anti-NMDAR encephalitis is caused by the antibodies, which bind to extracellular conformal epitope in the NR1/NR2 heteromers of the NMDAR. The antibodies are usually detected in CSF/serum of young women with ovarian teratoma (OT), who typically developed schizophrenia-like psychiatric symptoms. Most patients developed seizures, followed by unresponsive/catatonic state, central hypoventilation, and bizarre orofacial-limb dyskinesias. Based on symptomatology and current NMDAR hypofunction hypothesis in schizophrenia, we speculated that the antibodies might cause inhibition of NMDAR in presynaptic GABAergic interneurons, causing a reduction of release of GABA. This results in disinhibition of postsynaptic glutamatergic transmission, excessive release of glutamate in the prefrontal/subcortical structures, and glutamate/dopamine dysregulation. Recent studies demonstrated that the antibodies cause reversible reduction in the numbers of cell-surface NMDAR and NMDAR clusters in postsynaptic dendrites, suggesting antibodies-mediated decreased function of NMDAR. Early tumor resection with immunotherapy is recommended in OT-positive cases but not in OT-negative cases. However, exploratory laparotomy may increase the chance to identify microscopic teratoma and improve the outcome if patients who were refractory to immunotherapy had anti-NMDAR antibodies and ovarian cyst.

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Yahoo!知恵袋 (1 users, 1 posts)

子宮じゃなくて卵巣だよね https://www.jstage.jst.go.jp/article/clinicalneurol/49/11/49_11_774... 画像だけの検索なら、さらに調べるために試験開腹するのもありとある また顕微鏡レベルでしか確認できないのであれば摘出もとある 結局予後を一番改善しうる選択肢は卵巣の摘除にあるということでしょうう? ...

Twitter (39 users, 58 posts, 24 favorites)

病名が判明していなかった頃(2007年以前)の抗NMDA 受容体抗体脳炎患者他でも、そんな風にいわれる立場になっちゃいませんか? https://t.co/SJ1DHc8mTa https://t.co/fGOQ8l98pN
J-stageより「抗NMDA受容体抗体脳炎の臨床と病態」 https://t.co/TW5uoXeS9u(PDF) #仰天ニュース
Retweeted sinwanohate・レイジ (@sinwanohate): HPVワクチンの副作用にNMDA型グルタミン酸受容体に対する自己免疫が関わっているかもしれないという話。「抗 NMDA... https://t.co/chcQygxESc
Retweeted sinwanohate・レイジ (@sinwanohate): HPVワクチンの副作用にNMDA型グルタミン酸受容体に対する自己免疫が関わっているかもしれないという話。「抗 NMDA... https://t.co/OxDu8mQX0h
3 3 https://t.co/hmoZ26hvXr

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