儿童急性小脑性共济失调1例报告  

Acute cerebellar ataxia associated with SARS-CoV-2 infection in children:a case report

作　　者：张琰 王彩红 王金辉 俞蕙[4] 林彩梅 ZHANG Yan;WANG Caihong;WANG Jinhui;YU Hui;LIN Caimei(Department of Neurology,Children′s Hospital of Fudan University at Xiamen,Xiamen Children′s hospital,Xiamen 361006,Fujian,China;Department of Infectious Diseases,Children′s Hospital of Fudan University at Xiamen,Xiamen Children′s hospital,Xiamen 361006,Fujian,China;Department of Laboratory Medicine,Children′s Hospital of Fudan University at Xiamen,Xiamen Children′s hospital,Xiamen 361006,Fujian,China;Department of Infectious Diseases,Children′s Hospital of Fudan University,National Children′s Medical Center,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院厦门医院(厦门市儿童医院)神经内科,福建厦门361006 [2]复旦大学附属儿科医院厦门医院(厦门市儿童医院)感染科,福建厦门361006 [3]复旦大学附属儿科医院厦门医院(厦门市儿童医院)检验科,福建厦门361006 [4]国家儿童医学中心复旦大学附属儿科医院感染科,上海201102

出　　处：《临床儿科杂志》2024年第5期456-460,共5页Journal of Clinical Pediatrics

基　　金：厦门市医疗卫生指导性项目(No.3502Z20214ZD1251)。

摘　　要：回顾性分析1例新型冠状病毒(SARS-CoV-2)感染后急性小脑性共济失调患儿的临床资料和诊治过程,并进行相关文献复习。患儿,女,4岁11个月,因“咳嗽2周,发热3天”入院。入院第2天出现吟诗样语言,独坐不稳,走路不稳。予静脉人免疫球蛋白注射液总量2 g/kg(分4天)及静脉甲基强的松龙2 mg·kg^(-1)·d^(-1)治疗,病情明显好转后予醋酸泼尼松片口服(1 mg·kg^(-1)·d^(-1))并出院。出院11天电话随访患儿已基本恢复正常,遂停醋酸泼尼松治疗。文献报道3例患儿,均为男性,年龄分别为5岁、13岁、15岁;均为SARS-CoV-2感染后1~2周发病;临床表现均有共济失调步态;2例予静脉甲基强的松龙治疗,1例未予特殊治疗,3例均在2月内恢复正常。SARS-CoV-2感染所致急性小脑性共济失调一般为感染后1~2周出现,临床多表现为共济失调步态,多为感染后免疫反应所致,预后良好。To investigate the clinical characteristics and treatment of acute cerebellar ataxia in children associated with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection.The clinical features,neuroimages,therapy and prognosis of a girl with acute cerebellar ataxia associated with SARS-CoV-2 infection who was hospitalized in Children′s Hospital of Fudan University at Xiamen were retrospectively analyzed and the related literature were summarized.The patient was a girl aged 4 years and 11 months.She was admitted due to cough for 2 weeks and fever for 3 days.On the 3rd day of admission,she was treated by intravenous human immunoglobulin injection with a total amount of 2 g/kg(divided into 4 days)and with methylprednisolone 2mg/kg.After significant improvement,she was discharged from hospital with oral prednisone acetate at 1mg/kg/d.At 11 days of follow-up,the girl had returned to normal,and prednisone was stopped.Three articles and 3 children with acute cerebellar ataxia associated with SARS-CoV-2 infection were reported.The age of onset was 5 years old,13 years old,and 15 years old,respectively.All 3 cases were males,and the onset was 1-2 weeks after SARS-CoV-2 infection.All of them had ataxia gait.Two patients treated with intravenous methylprednisolone,and they were recovered to normal within 2 months.Acute cerebellar ataxia caused by SARS-CoV-2 infection usually appears 1 to 2 weeks after infection,and the clinical manifestations were ataxic gait,which was mostly caused by post-infection immune response,and the prognosis was good.

关 键 词：新型冠状病毒 急性小脑性共济失调 儿童 

分 类 号：R744.7[医药卫生—神经病学与精神病学]