PT -期刊文章盟艾玛·奥罗斯科AU -郭永盟-约翰·j·陈盟Divyanshu Dubey AU -布拉德利·豪厄尔盟玛格丽特Moutvic AU -埃里克·k·圣路易斯盟安德鲁·麦肯TI -临床推理:一名43岁男子与亚急性发作的视觉干扰,下巴痉挛,平衡和睡眠困难援助- 10.1212 / WNL。0000000000200950 DP - 2022年8月30日TA -神经病首页学第六PG - 387 - 392 - 99 IP - 9 4099 - //www.ez-admanager.com/content/99/9/387.short 4100 - //www.ez-admanager.com/content/99/9/387.full所以Neurology2022 8月30日;99 AB -脑干综合症患者是可辨认的视觉障碍、不协调,步态问题,演讲和吞咽困难,最近诊断为睡眠症状。脑干疾病亚急性发作(禁用赤字的积累发展6 - 12周)通常的自身免疫性,感染,炎症,或浸润性肿瘤的原因。自体免疫性或传染性脑干障碍可能称为脑干脑炎或rhombencephalitis。与多种自身免疫性rhombencephalitis,我们描述一个病人被诊断线索包括以下:多样化的视觉和睡眠症状,破伤风,历史上和窒息;跷跷板眼球震颤、斜视眼阵挛、构音障碍、下颌肌张力障碍和情景性喉痉挛;微妙但纵向和nonenhancing T2 MRI异常在脑干和上颈线;和脑脊液寡克隆乐队。他的动作disorder-specific神经免疫球蛋白剖面显示ANNA-2 (anti-Ri)和KLHL-11-IgG。两者都是多种生物标志物脑干脑炎。 KLCHL-11-IgG has been reported to accompany germ cell tumors, which was found in a solitary metastasis to the left inguinal lymph node in our patient, along with an atrophic left testis. Multidisciplinary treatment (autoimmune neurology, sleep medicine, ophthalmology, and physiatry) led to significant clinical improvements. This case provides a framework for the evaluation of patients with subacute-onset brainstem syndromes and the investigation and management of those with paraneoplastic and other autoimmune diseases.