脑、脑膜、脑神经、脑血管、周围神经受累的结核性脑膜炎一例  

A case of tuberculous meningitis involving the brain,meninges,cranial nerves,cerebral blood vessels,and peripheral nerves

作　　者：王爽[1] 张红丽[1] 冯雪丹 邱峰 冯锦丽[1] Wang Shuang;Zhang Hongli;Feng Xuedan;Qiu Feng;Feng Jinli(Department of Neurology,the Eighth Medical Center,PLA General Hospital,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心神经内科,北京100091

出　　处：《脑与神经疾病杂志》2024年第12期745-750,共6页Journal of Brain and Nervous Diseases

基　　金：解放军总医院第八医学中心面上重点项目(2019ZD-007)。

摘　　要：目的探讨结核性脑膜炎(TBM)可能出现的并发症、相关机制及治疗方案。方法分析1例诊断为TBM患者的临床症状、并发症及诊疗经过,对相关并发症发病机制进行总结。结果TBM患者可以出现头痛、肢体无力、言语不清、眼球运动障碍、口角歪斜、肢体麻木等脑膜、脑实质、脑神经以及周围神经受累表现。周围神经系统受累可能与感染、炎症浸润、免疫介导机制或抗结核药物相关,多数患者在足量、全疗程抗结核及补充维生素、营养神经等药物治疗后症状改善。结论TBM可累及脑、脑膜、脑神经、脑血管、周围神经,需与其他原因引起的类似症状相鉴别,以指导治疗,改善预后。Objective To explore the possible complications,related mechanisms,and treatment plans of tuberculous meningitis(TMB).Method Analyze the clinical symptoms,complications,and diagnosis and treatment process of a patient diagnosed with TMB,and summarize the pathogenesis of related complications.Result Patients with TMB may present with symptoms such as headache,limb weakness,unclear speech,eye movement disorders,crooked corners of the mouth,numbness in the limbs,and involvement of the meninges,brain parenchyma,cranial nerves,and peripheral nerves.The involvement of the peripheral nervous system may be related to infection,inflammatory infiltration,immune mediated mechanisms,or anti tuberculosis drugs.Most patients improve their symptoms after sufficient and full course of anti tuberculosis treatment,as well as supplementing vitamins,nourishing nerves,and other medications.Conclusion TMB can affect the brain,meninges,cranial nerves,cerebral blood vessels,and peripheral nerves,and should be distinguished from similar symptoms caused by other reasons to guide treatment and improve prognosis.

关 键 词：结核性脑膜炎 脑神经 脑梗死 周围神经 

分 类 号：R529.3[医药卫生—内科学]