中英VGKC复合物抗体相关的边缘性脑炎及

A72-year-oldmanpresentedwithcognitivedeclineandunilateralmusclejerks.Threemonthspriortopresentation,thepatientsuddenlydevelopedviolentmusclejerksinvolvingtherightsideofhisbodyandfacethatimpairedhisgaitandbalance.Approximately1weeklater,heacutelydevelopedconfusionandmemoryloss.Overthefollowingweeks,heexperiencedfluctuatingsymptomsofconfusion,memoryimpairment,insomnia,andparanoiddelusions.Hismusclejerksandunstablegaitwereintermittentwithreturntobaselineinbetweenattacks,buttheyincreasedinfrequencyandoccurredmanytimesthroughouttheday.Hewasfoundtobemildlyhyponatremicandwaseventuallyadmittedtoapsychiatricwardfortreatmentofacutepsychosis.

72岁男性，表现为认知功能衰退和单侧肌肉抽搐。发病前三个月，患者突发右侧肢体和面部剧烈的肌肉抽搐，导致步态不稳，平衡失调。大约1周后，病情急性进展，出现意识模糊和记忆丧失。在接下来的数周内，表现为意识模糊、记忆障碍、失眠和偏执性妄想，症状呈波动性。肌肉抽搐和步态不稳间断发作，发作间期恢复到基线状态，但是，发作频率增加，每日数次。检验结果示轻度低钠血症，最终被送往精神科治疗急性精神病。

Thepatient’smedicalhistorywassignificantforhypertension,well-controlleddiabetes,andamyocardialinfarction22yearspreviously.Hewasaretiredmechanicalengineerandwasphysicallyactivepriortotheonsetofsymptoms.

患者重要的既往史是高血压病，糖尿病，血糖控制良好，22年前患心肌梗死。是一名退休的机械工程师，症状发作前身体状况良好。

Onneurologicexamination,thepatientwasalertandorientedtopersononly.Heregistered3itemsbutwasunabletorecallthemat5minutesandwasunableto