亚急性联合变性不典型性三例分析  

Analysis of 3 atypical cases of subacute combined degeneration

作　　者：高金立[1] 刘尖尖[1] 高蕾[1] 李卫东[1] 张颖[1] 杜铁英[1] 黄光[1] GAO Jin-li;LIU Jian-jian;GAO Lei;LI Wei-dong;ZHANG Ying;DU Tie-ying;HUANG Guang(Department of Neurology, the Fuxing Hospital Affiliated of Capital University of Medical Science ,Beijing 100038,China)

机构地区：[1]首都医科大学附属复兴医院神经内科,北京100038

出　　处：《脑与神经疾病杂志》2016年第8期513-518,共6页Journal of Brain and Nervous Diseases

摘　　要：目的探讨不典型亚急性联合变性患者临床与影像学表现,以及避免误诊的临床体会。方法分析3例不典型亚急性联合变性患者的临床表现和辅助检查资料,探讨其临床表现及早期误诊经过。结果3例患者不典型表现分别为治疗期间出现的激素副作用导致的"中心性浆液性脉络膜视网膜病变"、腰膨大病变与髓内病灶。结论不典型亚急性联合变性,临床表现多样,突出且持续的后索损害及症状体征的选择性、对称性是本病特点,对其认识不足是造成早期误诊原因。Objective To explore the cilinical and radiological presentation of subacute combineddegeneration(SCD). Method We retrospectively studied 3 cases of hospitalized patients with SCD. Their clinicalinformation and results of associated tests were collected. Then we tried to discuss the causes of misdiagnosis in theearly stage.Results The atypical presentation of the 3 cases were: one with central serous chorioretinopathy(CSC)during steroid therapy; one with intumescentia lumbalis lesion; and one with huge intramedullary lesion.Conclusions The diagnosis criteria for SCD has not been well published. Symptoms of SCD may vary, but prominent and consistentsigns of posterior columns disorder, the selectivity and symmetrical characteristic of the symptoms and signs are the keypoints of making the diagnosis.

关 键 词：亚急性联合变性 磁共振 误诊 

分 类 号：R744.6[医药卫生—神经病学与精神病学]