以帕金森综合征为主要表现的成人乙型脑炎的临床及影像学特点(附1例报告)  

Clinical and imaging features of adult Japanese encephalitis with the main manifestation as Parkinson syndrome( report of 1 case)

作　　者：曹洁[1] 张颖冬[1] 

机构地区：[1]南京医科大学附属南京医院神经内科,210006

出　　处：《临床神经病学杂志》2014年第4期303-305,共3页Journal of Clinical Neurology

摘　　要：目的探讨以帕金森综合征为主要表现的成人乙型脑炎(乙脑)的临床及影像学特点。方法回顾性分析1例成人乙脑患者的临床资料。结果本例患者为女性,33岁;在夏季急起发热、头痛;发病后第11 d(恢复期)发热、头痛缓解后,出现少语、运动迟缓、动作少、震颤、四肢肌张力齿轮样增高。头颅MRI示双侧中脑对称性条片状T1WI等低信号、T2WI高信号影。血清乙脑病毒IgM抗体(+)。经脱水、抗病毒、糖皮质激素及多巴制剂治疗,患者的病情显著改善,基本痊愈。结论对在乙脑流行季节,急起发热、头痛后出现帕金森综合征的表现,MRI示中脑病变者,应考虑乙脑的可能。血或CSF乙脑病毒IgM抗体检测是确诊的主要依据。Objective To explore the clinical and imaging features of aduh Japanese encephalitis （JE） with Parkinson syndrome as the main manifestation. Methods The clinical data of an adult patient with JE were analyzed. Results This patient was female, 33 years old. The clinical manifestations were acute onset in summer, fever and headache. Headache and fever remission were at lhh d after admission, followed by hypophonia, bradykinesia, hypokinesia, tremor and dystonia, MRI showed symmetrical strip signal in the double midbrain was equal or low signal on TIWI and high signal on T2WI. IgM antibody of JE virus in the serum was positive. Treatments such as dehydration, antivirus, glucocorticosteroid and dopamine preparation had stable therapeutic efficacy, and the patient was basically cured. Conclusions When a patient presents with fever and headache followed by Parkinson syndrome during JE epidemic season and lesions appear in the bilateral midbrain in MRI, the diagnosis of JE must be taken into concern. This disease is diagnosed mainly depended upon IgM antibodies against JE virus in the serum or the cerebrospinal fluid.

关 键 词：乙型脑炎 成人 帕金森综合征 临床表现 

分 类 号：R742.5[医药卫生—神经病学与精神病学]