误诊为单纯疱疹病毒性脑炎的MELAS型线粒体脑肌病  

MELAS syndrome of mitochondrial encephalomyopathy that misdiagnosed as herpes simplex encephalitis

作　　者：杨立波 艾明华 王艳玲 李文彬[2] 

机构地区：[1]沧州市人民医院神经内科,河北沧州061000 [2]北京市首都医科大学附属宣武医院,北京100053

出　　处：《中风与神经疾病杂志》2008年第1期79-81,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的分析误诊为单纯病毒性脑炎(HSE)的3例线粒体脑肌病伴乳酸血症和卒中样发作(MELAS综合征)的原因。方法分析3例误诊为HSE的MELAS综合征患者的临床资料。结果患者主要表现为反复发热、头痛、抽搐发作、视力下降等,其中发热、头痛是3例患者的共同临床表现。影像学检查可见脑叶受累,表现为典型的层状坏死,可见脑萎缩,未发现海马、颞叶内侧面、岛叶、额叶眶面的异常信号。肌肉活检可见破碎红纤维(RRF)、异常线粒体增多。结论MELAS综合征和HSE有相似的临床表现,但是其反复发作的特点和影像学表现与HSE有明显的不同,而病毒感染可能是引起发热和临床发作的诱因。Objective To analyze clinical characteristics of 3 eases of MELAS syndrome that misdiagnosed as hepers simplex virus encephalitis（HSE）. Methods The clinical data of 3 eases of MELAS Syndrome that misdiagnosed as HSE were analysised seriatim. Result The main manifestation of 3 eases were repeated fever, headache, seizure, descent of eyesight. Fever and headache were the common symptom to the 3 eases. Imaging examinations signal can be found in the erea of hippoeampus,inboard of temporal lobe. insula eye socket of frontal lobe. Muscle biopsy showed red ragged fibers and abnrumal mitochondia in all cases. Conclustion The clinical manifestation of MELAS syndrome are similar to HSE. But the repeatation and image results are obviously different from HSE. The inducement of fever and clinical attack may be infection of virus.

关 键 词：线粒体脑肌病伴乳酸血症和卒中样发作(MELAS综合征) 单纯疱疹病毒性脑炎(HES) 影像学 诱因 

分 类 号：R746[医药卫生—神经病学与精神病学]