安钠咖相关脑损害三例临床与磁共振成像特点  

Clinical manifestation and MRI feature on three patients of toxic encephalopathy after inhaling caffeine and sodium benzoate

作　　者：邢玉平[1] 张丽芳[1] 王玉芬[1] 孙万里[2] 武桂花[1] 申亚巍[1] 崔丽霞[1] 

机构地区：[1]长治医学院附属和平医院神经内科,山西省长治市046000 [2]长治医学院附属和平医院磁共振科,山西省长治市046000

出　　处：《中华神经科杂志》2009年第11期754-757,共4页Chinese Journal of Neurology

基　　金：基金项目：山西省青年科学基金资助项目（2008021046-5）

摘　　要：目的探讨安钠咖相关脑损害的临床表现及磁共振成像（MRI）特征。方法对3例安钠咖相关脑损害患者进行临床及MRI观察。结果3例均为男性，均有明确的烫吸安钠咖史（烫吸时间3—7年），除具有反应迟钝、智力障碍等常见的中毒性脑病特征外，尚有特殊的语言及肌张力障碍；头颅MRI显示双侧对称性大脑半球、内囊后肢、胼胝体、双侧大脑脚、脑桥的广泛脱髓鞘改变。3例经皮质激素、神经营养等治疗，在病后40d病情均明显好转，仅例1残留轻度情感控制障碍。结论安钠咖相关脑损害有特殊的语言及肌张力障碍，MRI存在广泛脱髓鞘，了解这些特点可为预防和治疗安钠咖引起的并发症提供帮助。Objective To study the clinical manifestation and MRI feature of toxic encephalopathy after inhaling caffeine and sodium benzoate. Methods Three patients with toxic eneephalopathy induced by inhaling caffeine and sodium benzoate were observed clinically and with MRI. Results The 3 patients were male. They all had definite addiction histories （the time of addiction for 3 years to 7 years ）. There were special language and retropulsive dystonia besides the common characteristics of toxic encephalopathy： reaction retardation and disturbance of intelligence. MRI showed the change of generalized demyelination in bilateral symmetrical cerebral hemisphere, posterior limbs of internal capsule, corpus callosum, medial lemniscus, and cerebellum hemisphere dentate nucleus. The clinical symptoms of 3 patients were significantly improved 40 days after the adrenocortical steroid and neurotrophic treatment. The mild mood disorder remained in case 1. Conclusion Clinical manifestation and MR1 of toxic encephalopathy after inhaling caffeine and sodium benzoate are known, so we could diagnose the patients of the disease in time.

关 键 词：咖啡因 苯甲酸钠 中毒 脑损害 慢性 磁共振成像 

分 类 号：R686[医药卫生—骨科学]