阵发性交感神经过度兴奋五例诊治分析并文献复习  

Paroxysmal Sympathetic Hyperactivity:Analysis of Five Cases and Literature Review

作　　者：朱衡亚[1] 罗小春[2] 刘泉坤[1] 

机构地区：[1]浙江省湖州市中心医院神经内科,313000 [2]中国人民解放军第九八医院神经内科

出　　处：《中国全科医学》2014年第5期552-554,共3页Chinese General Practice

摘　　要：目的 探讨阵发性交感神经过度兴奋（PSH）的临床表现及诊治方法,提高对PSH的认识.方法 回顾性分析2009年2月-2013年5月我院神经内、外科病房及外院高压氧中心诊治的5例PSH患者的临床表现、实验室检查及治疗等资料.结果 5例患者中男4例、女1例,年龄25~77岁,其中严重脑创伤2例、反复脑梗死1例、缺血缺氧性脑病1例、脑出血1例.5例患者主要以阵发性躁动、高热、瞳孔散大、心动过速、血压升高、多汗、呼吸急促、肌张力障碍或姿势异常为临床表现.首次发作距原发病时间为1~60 d,发作时间为数分钟至半小时,发作频率1~10次/d,未发现昼夜规律,吸痰和排便为其可能的诱因.影像学检查提示颅脑损伤部位分散于额叶、顶叶、枕叶、颞叶、丘脑、小脑及脑干.抗癫痫治疗疗效不佳.结论 PSH病因不一,临床表现多样,早期容易误诊,目前主要是对症治疗.Objective To study the clinical features of paroxysmal sympathetic hyperactivity （PSH）, to improve the understanding of PS[-I. Methods A retrospective analysis was carried out on clinical manifestations, laboratory examinations, treatment of 5 patients diagnosed as PSH in this hospital from February 2009 to May 2013. Results Of the five patients, 4 were male and 1 female. Aged 25 ~ 27 years, including 2 severe brain trauma, 1 recurrent infarction, 1 hypoxic - ischemic encepha- lopathy, 1 cerebral hemorrhage. The 5 patients presented mainly with paroxysmal restlessness, fever, mydriasis, tachycardia, elevated blood pressure, sweating, shortness of breath, abnormal posture dystonia. The time from the first episode to the prima- ry disease was 1 ~ 60 d, the onset lasted several rain to half an hour. Seizure frequency was 1 - 10 times/＆ No circadian rhythm was found, aspiration of sputum and defecation were possible incentives. Imageological examination showed that craniocerebral trauma sites dispersed in the frontal lobe, parietal lobe, occipital lobe, temporal lobe, thalamus, cerebellum and brain stem. The effect of antiepileptic treatment was poor. Conclusion The reasons for PSH are different, with various clinical manifesta- tions. It is easy to be misdiagnosed in early stage. The current treatments are mainly symptomatic.

关 键 词：交感神经系统 肌张力过强 诊断 治疗 

分 类 号：R338[医药卫生—人体生理学]