广州管圆线虫致嗜酸细胞性脑脊膜神经根炎  

Eosinophilic meningoradiculitis caused by Angiostrongylus cantonensis

作　　者：陈秀芸[1] 黄向东[1] 曾世斌 

机构地区：[1]浙江省温州市第二人民医院神经内科,325000

出　　处：《中华神经科杂志》1999年第6期341-343,共3页Chinese Journal of Neurology

摘　　要：目的　报道１０ 例广州管圆线虫引起的嗜酸细胞性脑脊膜神经根炎，以期提高对该病的认识和重视。方法　对１０ 例患者的临床全过程及实验室检查进行系统的观察及随访，并结合当地流行病学资料及国内外文献，实行对比研究。结果　该组病例具有如下特征：①急性起病（１０ 例） ；②剧烈头痛（１０ 例） 和（或）躯体痛性感觉障碍（８ 例），伴发热（８ 例） 、全身违和（１０ 例） ；③可有脑神经（３例）或脊神经根（８ 例）受累；④无明显颈抵抗及病理征（１０ 例） ；⑤脑脊液（６ 例） 及外周血（１０ 例）中嗜酸细胞数增高；⑥血清和脑脊液广州管圆线虫蚴抗体均呈阳性（５／５ 例） ；⑦病程自限，预后良好（１０例）；⑧病前食用过生淡水螺肉（８ 例）；⑨所在地为广州管圆线虫新疫源地；⑩已排除其他蠕虫感染。结论　一度在温州暴发流行的一种“怪病”实属广州管圆线虫所致的嗜酸细胞性脑脊膜神经根炎。Objective To report ten cases of eosinophilic meningoradiculitis caused by Angiostrongylus cantonensis which should be well recognized and paid more attention to. Methods The ten cases consisted of six inpatients and four outpatients of our hospital, including 6 females and 4 males. Their ages were 24 48 years with an average of 33.5 years. The whole clinical courses and laboratory data of the patients were systematically observed and followed up with epidemiological investigation for half a year. The previous reports were also studied as the controls. Results The clinical manifestations of the ten patients comprised: acute onset (10/10), severe headache (10/10), painful paresthesia (8/10), fever (8/10) and malaise (10/10). Headache was the most prominent symptom occurring usually in intermittent attacks, the common sites being located in the occipital, frontal and bitemporal regions. Body paresthesia were expressed as severe skin pain exacerbated by the slightest touch (8/10), numbness (2/10), itching (2/10) and sensation like worms crawling on the skin (1/10). Occasionally diplopia (2/10) and facial paralysis (1/10) might be developed. Signs of the central nervous system such as neck stiffness and kernigs sign were not evident. Tendon reflexes might be decreased (5/10) or increased (2/10). Pathologic reflexes (10/10) were not demonstrated. Laboratory findings were as follows: (1) Hemogram showed WBC count to be (8.5 12.5)×10 9/L and Eosinophilic count to be 0.08～0.21. (2) The CSF became slight cloudy in gross appearance and the CSF pressures were found to be 1.67～2.25 kPa. WBC count in the CSF was (470～1 100) ×10 6/L, Eosinophillic was 0.08～0.60 and protein was 0.73～1.44 g/L. Both glucose and chloride were normal. Detection of the antibodies of A.Cantonensis by ELISA method in CSF and sera of 5 cases were all positive (5/5). No parasite was recovered. The bacteria cultures were negative. (3) Mild abnormalities on the EEG were found in eight cases and moderate abnormalities w

关 键 词：管圆线虫 神经根炎 嗜酸细胞性 

分 类 号：R745.430.2[医药卫生—神经病学与精神病学]