摘要
目的探讨抗GQ1b抗体阳性的Bickerstaff脑干脑炎的诊断学特征。方法回顾分析2016年2月至2019年5月经广东三九脑科医院神经内科确诊的3例抗GQ1b抗体阳性的Bickerstaff脑干脑炎患者的临床资料,总结抗GQ1b抗体阳性的Bickerstaff脑干脑炎的诊断学特征,并复习相关文献。结果患者均为女性,年龄分别为16岁、19岁、49岁,发病前均有感染病史。3例均以共济失调起病,2例起病时伴有四肢无力,1例加重后出现意识障碍、四肢无力。3例患者均有眼肌麻痹,2例患者锥体束征阳性。3例患者抗GQ1b抗体均为阳性,头颅磁共振成像平扫及强化扫描未见明显异常,2例患者肌电图诱发电位检查异常,1例患者检查正常。结论Bickerstaff脑干脑炎临床上主要表现为急性眼肌麻痹、共济失调,可伴有意识障碍和(或)锥体束征阳性的综合征,结合血清抗体、影像学及神经电生理检查方能正确诊断。
Objective To explore the diagnostic features of Bickerstaff brainstem encephalitis(BBE)with positive anti-GQ1b antibody.MethodsThe clinical data of 3 BBE cases with positive anti-GQ1b antibody diagnosed by the Neurology Department of Guangdong Sanjiu Brain Hospital from February 2016 to May 2019 were retrospectively analyzed.Diagnostic features of BBE with positive anti-GQ1b antibody were summarized,and relevant literatures were reviewed.ResultsThe 3 patients were all female,with the age of 16,19,49 years old respectively,and all of them had a history of infection before the onset.All 3 cases had onset of ataxia,2 cases had limb weakness at the onset,and 1 case developed consciousness disorder and limb weakness after aggravation.On physical examination,3 patients had ophthalmoplegia,and 2 patients had positive pyramidal tract signs.Auxiliary examination:3 patients presented positive of anti-GQ1b antibodies,3 patients showed no obvious abnormalities in brain magnetic resonance imaging(MRI)scan and enhancement,2 patients had abnormal electromyogram evoked potentials,and 1 patient was normal.ConclusionsBBE is a syndrome that mainly manifests as acute ophthalmoplegia,ataxia accompanied by disturbance of consciousness and/or positive pyramidal tract signs.Thorough understanding of associated clinical features and serum antibody,imaging and nerve electrophysiological examination are helpful in achieving at the correct diagnosis.
作者
赵名娟
王展航
徐玉振
叶锦龙
匡祖颖
李丹丹
Zhao Mingjuan;Wang Zhanhang;Xu Yuzhen;Ye Jinlong;Kuang Zuying;Li Dandan(Department of Neurology, Taian Municipal Hospital, Taian 271000, China;Department of Neurology, Guangdong Sanjiu Brain Hospital, Guangzhou 510000, China;Department of Neurology, Taian City Central Hospital, Taian 271000,China)
出处
《中华诊断学电子杂志》
2021年第4期255-258,共4页
Chinese Journal of Diagnostics(Electronic Edition)
