伴两侧面部及同侧下肢麻木的Wallenberg综合征1例并文献复习  

Wallenberg syndrome with bilateral facial and ipsilateral lower extremities numbness:a case report and literature review

作　　者：颜谈 王幼萌[1] 许静[1] 陈巨罗 汝宁[1] YAN Tan;WANG Youmeng;XU Jing;CHEN Juluo;RU Ning(Author Affiliation:Department of Neurology,People's Hospital of Fuyang,Fuyang,Anhui 236000,China)

机构地区：[1]阜阳市人民医院神经内科,安徽阜阳236000

出　　处：《安徽医药》2022年第10期2001-2004,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的分享1例极少见的Wallenberg综合征的变异型(两侧面部及同侧下肢麻木)病人,为大家的医疗诊治给予一定的帮助。方法回顾性分析2019年6月1日阜阳市人民医院收治的1例延髓背外侧梗死病人的病因、机制、症状体征、检验检查、用药情况及治疗效果等,参阅各种Wallenberg综合征相关文献,详细分析了该类疾病的病因、少见症状、体征、解剖学特点及其机制。结果病人主诉声嘶、双下肢乏力3 h。入院诊断为延髓背外侧梗死、冠心病、心房颤动、心功能不全2级、高血压病2级(极高危)、2型糖尿病、丙型肝炎。予以静脉溶栓、抗栓、调脂固斑、保护脑组织、扩容、补液、改善微循环等处理。出院时病人病情明显改善。本病例除具有经典Wallenberg综合征临床表现外,还具有罕见的两侧面部及同侧下肢麻木,同侧面部周围性瘫痪,同侧舌下神经损伤等临床表现。结论Wallenberg综合征病人临床特点及其解剖结构极其复杂,且相关机制有待进一步阐明。Objective To share a rare case of Wallenberg syndrome variant(bilateral facial and ipsilateral lower extremities numbness)patient,so as to provide a reference for the clinical diagnosis of similar cases.Methods We retrospectively analyzed the etiology,clinical manifestations,auxiliary examinations,treatment methods along with therapeutic effects of a patient diagnosed with dorsolateral medullary infarction admitted to People's Hospital of Fuyang on June 1st,2019.The etiology,rare symptoms,physical signs,anatomical characteristics and related mechanisms of this disease were analyzed in detail with reference to various literatures related to Wallenberg syndrome.Results The patient complained of hoarseness and weakness of both legs for 3 hours.Admission diagnosis:dorsolateral medulla oblongata infarction,coronary heart disease,atrial fibrillation,cardiac insufficiency grade 2,hypertension grade 2(very high risk),type 2 diabetes,chronic bronchitis,hepatitis C,prostatic hyperplasia,intravenous thrombolysis.Antiplatelet aggregation,anticoagulation,lipid regulation and plaque fixation,protection of brain cells,expansion,fluid supplementation,improvement of microcirculation and other treatments were performed.The patient's condition was significantly improved upon discharge.In addition to the classic clinical manifestations of Wallenberg syndrome,this patient also had rare clinical manifestations such as numbness on both sides of the face and ipsilateral lower limb,ipsilateral peripheral paralysis,ipsilateral hypoglossal nerve injury.Conclusion The clinical characteristics and anatomic structure of the patients with Wallenberg syndrome are extremely complex,and the relevant mechanisms want to be further illuminated.

关 键 词：延髓外侧综合征 感觉障碍 血栓溶解疗法 机制 

分 类 号：R743[医药卫生—神经病学与精神病学]