新型冠状病毒感染相关急性坏死性脑病1例  

A case report of COVID-19-associated acute necrotizing encephalopathy

作　　者：赵莉[1] 李先志[2] 闫莉婷 李怡 王晓麒[1] 杨笑[1] ZHAO Li;LI Xianzhi;YAN Liting;LI Yi;WANG Xiaoqi;YANG Xiao(Department of Neurology,General Hospital of Ningxia Medical University,Yinchuan 750000,China)

机构地区：[1]宁夏医科大学总医院神经内科,银川750000 [2]宁夏石嘴山市第二人民医院重症科

出　　处：《中国神经精神疾病杂志》2024年第3期156-158,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：报告1例成人新型冠状病毒感染相关的急性坏死性脑病(COVID-19-associated acute necrotizing encephalopathy,ANEC)病例。患者在新型冠状病毒感染后12 d出现意识障碍、癫痫发作,脑MRI上显示双侧丘脑、脑干、小脑半球为主的信号改变,与急性坏死性脑病(acute necrotizing encephalitis,ANE)特征性影像表现一致。早期给予甲泼尼龙冲击联合大剂量人免疫球蛋白治疗,但患者一直处于持续昏迷状态并最终死亡。ANEC往往起病急,进展快,以意识障碍、癫痫等为主要表现,影像学丘脑及幕下对称性、多灶性病灶对诊断具有特异性,但治疗及预后仍面临挑战,需要深入研究。This article reports one case of adult COVID-19-associated acute necrotizing encephalopathy(ANEC).The patient developed disturbance of consciousness and seizure on the 12th day after SARS-CoV-2 infection.Imaging showed significant swelling and signal changes in the bilateral thalamus,brainstem,cerebral hemisphere and cerebellar hemisphere,which were consistent with the characteristic images of Acute necrotizing encephalitis(ANE).Although methylprednisolone shock therapy and high-dose human immunoglobulin therapy were given early,the patient died.ANEC often starts quickly and progresses rapidly,unconsciousness and seizure are the main manifestations.Imaging features of thalamic and subtentorial symmetry and multifocal lesions are specific for diagnosis,but the treatment and prognosis still face challenges and need further study.

关 键 词：新型冠状病毒 急性坏死性脑病 新型冠状病毒感染相关急性坏死性脑病 意识障碍 癫痫 丘脑病变 预后 

分 类 号：R742[医药卫生—神经病学与精神病学]