摘要
目的分析肺部感染继发伴有可逆性胼胝体压部病变的临床症状轻微的脑炎/脑病(MERS)患者的临床特征。方法收集温州医科大学附属台州医院神经内科2016年收治的2例肺部感染继发MERS患者的临床资料和影像学资料,总结其临床特征。结果 2例患者均为年轻男性,发病前均有发热、咳嗽等肺部感染症状,随后出现头痛、恶心、呕吐、精神异常等神经系统症状,早期均行左氧氟沙星针抗感染治疗。颅脑MRI均表现为胼胝体压部的T1加权像(T1WI)低信号、T2加权像(T2WI)高信号、弥散加权成像(DWI)高信号的病灶,腰椎穿刺示脑脊液压力增高,实验室检查正常,予抗感染、B族维生素营养神经、甘露醇脱水降颅内压治疗后好转,复查颅脑MRI胼胝体压部病变消失。结论本组2例患者发病前均有肺部感染症状,随后出现神经系统症状,临床特点、辅助检查结果均与既往文献的资料相符。肺部感染是继发MERS的病因之一,可能与早期使用左氧氟沙星针治疗有关。
Objective To analyze the clinical characteristics of mild encephalitis/encephalopathy with a reversible splenial lesion（MERS） of the corpus callosum secondary to pulmonary infection.Methods We summarized the clinical characteristics of 2 cases with MERS of the corpus callosum secondary to pulmonary infection admitted in Department of Neurology of Taizhou Hospital Affiliated to Wenzhou Medical University in 2016 based on reviewing their clinical and imaging data.Results Both the 2 cases were young males who had prodromal symptoms of MERS of the corpus callosum（lung infection symptoms such as fever,cough,followed by nervous system symptoms such as headache,nausea and vomiting and mental abnormalities）,and were given levofloxacin as the early treatment against infections.Brain magnetic resonance imaging（MRI） findings of them showed a splenial lesion of the corpus callosum that was characterized by low signals on T1WI,high signals on T2WI and high signals on deffusion-weighted imaging（DWI）.Their cerebrospinal fluid（CSF） pressure measured during lumbar puncture was high,but laboratory results of CSF were normal.After receiving the treatment of anti-infection,nourishment of the nerves by taking B vitamins,dehydration and reduction of intracranial pressure by mannitol,all the conditions of them were improved,and the splenial lesions of the corpus callosum disappeared found by the brain MRI reexamination.Conclusion The prodromal symptoms（pulmonary infection,followed by neurological symptoms） of MERS of the corpus callosum,clinical features and auxiliary examination results of the 2 cases in this study are consistent with the records in the previous related literature.Pulmonary infection is one of the secondary causes of MERS of the corpus callosum,which may be related to the early levofloxacin treatment.
出处
《中国全科医学》
CAS
北大核心
2017年第18期2263-2266,共4页
Chinese General Practice
关键词
肺部炎症
胼胝体
脑炎
体征和症状
Lung inflammation
Corpus callosum
Encephalitis
Signs and symptoms
