摘要
目的探讨以视力下降为主要表现的神经梅毒患者的临床特点、诊断和治疗。方法分析9例视力下降为主的神经梅毒患者临床特点、血清学变化、影像异常、治疗及预后。结果本组病例9例,其中男性6例,女性3例,平均年龄47.22±12.96岁,通过血清和脑脊液快速血浆反应素试验、梅毒螺旋体明胶试验检查,结合脑脊液与头颅MRI检查结果,诊断为神经性梅毒,临床分型为脑脊髓膜型,经过驱梅治疗后,5例病人视力有不同程度提高,4例病人视力未有改善,但头痛、眼痛症状缓解。结论临床上神经梅毒以视力损害为主要表现者少见,容易误诊和漏诊,应提高对本病的认识,以使病人能在发病初期得到及时正规的治疗,避免严重后果。
Objective To study the clinical features of neurosyphilis initiated with visual impairment,diagnosis and treatment.Methods Nine cases of neurosyphilis initiated with visual impairment were analyzed retrospectively,and serological response,MRI presentations,treatment and prognosis were also studied.Results Six patients were male patients,three cases were female patients.Mean age was（47.22＋12.96）years.According to the findings of RPR,TPPA in serum and cerebral spinal fluid（CSF）,combined with abnormity of cell counts,total protein in CSF and MRI presentations,nine patients were diagnosed neurosyphilis.All patients were considered as syphilitic cerebrospinal meningitis.By antisyphilitic treatment,five patients visual acuity were improved more or less,four patients had no improvement,the symptoms of headache and eye pain were complete remission.Conclusion The neurosyphilis initiated with visual impairment is rare,it can be easily misdiagnosed and neglected,so we should reinforce our knowledge of this disease so that the patients can be treated in time and regularly,then we can keep off the serious outcome.
出处
《脑与神经疾病杂志》
2012年第5期368-371,共4页
Journal of Brain and Nervous Diseases
关键词
神经梅毒
视神经
临床表现
Neurosyphilis
Optic nerve
Manifestation
