癫痫发作:三例神经型布氏杆菌病的不典型临床表现  

Seizure Onset: Three Cases of Atypical Clinical Presentations of Neurological Brucellosis

作　　者：祁维民 李海宁[1] 

机构地区：[1]宁夏医科大学总医院神经内科,宁夏 银川

出　　处：《亚洲急诊医学病例研究》2024年第3期76-81,共6页Asian Case Reports in Emergency Medicine

摘　　要：背景:神经型布氏杆菌病(NB)是由布氏杆菌引起的一种累及中枢神经系统的感染性疾病,它的临床表现多变,包括脑炎、脑膜炎、脑膜脑炎、神经根炎、脊髓炎、外周神经和颅神经病变等,癫痫是NB较为少见的临床表现。结果:本文报道了三例NB伴癫痫的病例。他们均出现头痛、发热等神经系统表现,布氏杆菌凝集试验均为阳性,且均有癫痫发作表现或脑电图有异常癫痫放电表现,经过利福平、多西环素等抗布氏杆菌治疗后症状均好转。结论:在布氏杆菌病流行的地区出现精神行为异常的患者应及时考虑癫痫发作的可能,并积极完善动态脑电图等相关检查,及时给予抗癫痫等相应治疗。Background: Neurological brucellosis (NB) is an infectious disease affecting the central nervous system caused by Brucella. Its clinical manifestations vary widely, including encephalitis, meningitis, meningoencephalitis, radiculitis, myelitis, peripheral nerve, and cranial nerve involvement. Seizure is a rare clinical manifestation of NB. Results: This article reports three cases of NB accompanied by seizures. All patients presented with neurological symptoms such as headache and fever. Brucella agglutination test was positive in all cases, and they exhibited seizure episodes or abnormal epileptic discharges on electroencephalogram (EEG). Symptoms improved after treatment with antibiotics effective against Brucella such as rifampicin and doxycycline. Conclusion: Patients with psychiatric abnormalities in areas endemic for brucellosis should be promptly evaluated for the possibility of seizures. It is essential to conduct comprehensive evaluations including dynamic EEG and initiate appropriate anti-epileptic therapy in a timely manner.

关 键 词：神经布鲁氏菌病 癫痫 脑脊液 布鲁氏菌 脑电图 

分 类 号：R74[医药卫生—神经病学与精神病学]