急性播散性脑脊髓炎8例临床分析  

Clinical analysis of acute 8 disseminated encephalomyelitis

作　　者：骆杭丽[1] 

机构地区：[1]浙江义乌市中心医院神经内科,义乌322000

出　　处：《中国实用神经疾病杂志》2007年第5期12-14,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的研究急性播散性脑脊髓炎(ADEM)的临床特点。方法对8例临床确诊为ADEM患者进行回顾及随访,并对临床和影像学表现等进行分析。结果(1)临床表现:5例病前有前驱感染或疫苗接种史,3例无明显诱因,神经系统症状多样。(2)影像学表现:主要累及脑白质的脱髓鞘病变,4例累及丘脑,2例累及脊髓。(3)治疗及预后:8例全用激素,其中7例予甲基泼尼松龙冲击。4例同时合用人血丙种球蛋白。8例均经6个月～2年随访,无复发,其中3例遗留后遗症。结论ADEM是一种中枢神经系统炎性脱髓鞘疾病,临床表现多样。MRI表现有一定的特征性,MRI检查有利于早期诊断,也是评价疗效的重要手段。Objective To study the clinical features of acute disseminated encephalomyelitis （ADEM）. Methods A retrospectively analysis and follow-up study were conducted in 8 patients with the diagnosis of ADEM to summarize the characteristics of clinical and imaging features etc. Results （1） Clinical manifestations ： herald infections and vaccine inoculations were rod in 5 patients . No forerunner was found in another 3 patients. Various symptoms of central nervous system occurred one by one or simultaneously in the illness process. （2） Imaging manifestations： Brain albe was involved mainly in demyelinating diseases. The thalamencephalons of 4 patients were involved. Spinal cords of 2 patients were involved. （3） Treatments and prognosisses ： All patients were administ hormone High dose methylprednisolone was administ in 7 patients. 4 patients received intravenous immunoglobulin. All patients showed good response and were taken follow-up from 6 months to 2 years. No recurrence occurred in them. 3 patients of them had longterm neurologic sequelae. Conclusion ADEM was a phlegogenic demyelinating disease with multiple clincal manifestations in central nervous system. Some determined marks were founded in MRI test. It was an important method for early diagno- sis and evaluating therapeutic effect.

关 键 词：急性播散性脑脊髓炎 临床分析 

分 类 号：R512.3[医药卫生—内科学]