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1.
目的:探讨脊髓灰质炎后综合征(PPS)的临床表现及电生理结果,分析其发病机制及危险因素。方法:总结2例PPS患者的临床资料并复习相关文献。结果:2例患者均中年起病,既往有脊髓灰质炎病史,在长达30年余的稳定期后出现了新的肌无力、肌萎缩和疲劳症状,经临床及电生理检查排除其他神经肌肉疾病后诊断为PPS。结论:PPS是一种感染脊髓灰质炎后出现的缓慢进展性运动神经元综合征,目前无特效治疗方法。  相似文献   

2.
脊髓灰质炎后综合征的临床表现(附3例报道)   总被引:2,自引:0,他引:2  
目的:研究脊髓灰质炎后综合征(PPS)的临床表现。方法:评价3例PPS患者的临床表现。结果:PPS的主要表现是新出现的肌无力、疲劳、疼痛和肢体及躯干缓慢进展的运动神经损害。PPS患者既往有脊髓灰质炎的病史,有部分或完全的神经功能恢复,有长达数十年的神经功能稳定期并除外其他疾病。结论:PPS是一种感染脊髓灰质炎后出现的缓慢进展性的运动神经元综合征。  相似文献   

3.
目的探讨脊髓灰质炎后综合征(PPS)的临床表现及电生理特征,以利于该病的诊断水平。方法收集河北医科大学第二医院神经内科就诊的2例PPS患者的临床资料,分析该病的主要临床表现及电生理特点。结果例1患者7岁时患脊髓灰质炎,遗留右下肢短小。60年后出现缓慢进展的左下肢无力,肌肉萎缩;例2患者3岁时患脊髓灰质炎,遗留双下肢屈曲畸形,脊柱向右侧弯曲。47年后出现双上肢进行性无力,肌肉萎缩,疼痛,疲乏等表现,2例患者肌电图检查均以轻收缩时运动单位电位时限增宽及电位波幅增高为主,安静状态下自发电位少见。结论 PPS是脊髓灰质炎发病后,临床症状稳定多年后再次出现缓慢进展的迟缓性瘫痪,肌电图主要表现为慢性的神经再生过程。  相似文献   

4.
目的总结肠道病毒71型感染重症手足口病合并脊髓灰质炎样综合征患儿的临床特征,为其诊断治疗提供依据。方法对18例肠道病毒71型感染重症手足口病合并脊髓灰质炎样综合征患儿的临床资料进行回顾性分析及随访。结果18例患儿中14例(77.78%)年龄2岁,单个肢体瘫痪12例(66.67%);神经电生理、磁共振检查神经损伤定位与临床表现一致;随访3个月,14例恢复正常,4例患儿存在不同程度的肌力减弱。结论重型手足口病并发脊髓灰质炎样综合征多发生于2岁的儿童,瘫痪以单个肢体为主;磁共振联合神经电生理检查可有效评估病情及预后。  相似文献   

5.
目的研究脊髓灰质炎后综合征的临床表现和电生理特点,探讨其诊断、鉴别诊断及诊疗方法。方法回顾性分析10例脊髓灰质炎后综合征患者的临床资料。结果 10例患者受累肢体肌力均有减弱,5例伴易疲劳,3例伴寒冷不耐受,5例伴肢体疼痛。典型电生理表现为运动单位电位时限增宽、波幅增高、募集相减少;运动及感觉神经传导均正常。结论脊髓灰质炎后综合征最常见表现为无力、慢性疲劳、疼痛,诊断主要依赖于病史、临床表现、电生理等相结合的综合分析,治疗主要为康复及药物治疗,早期干预可改善患者生活质量。  相似文献   

6.
颅脑外伤所致精神障碍46例临床分析   总被引:4,自引:1,他引:3  
分析了46例颅脑外伤所致精神障碍患者的临床资料。认为临床诊断时不应过分强调神经系统阳性体征和脑电图异常对本病的诊断价值,要对脑外伤史、临床特征、神经心理学等检查发现进行综合分析。在作出脑震荡后综合征诊断时,应注意排除导致这些症状的其他神经系统疾病。  相似文献   

7.
目的探讨桡神经深支旋后肌卡压综合征的临床特点和诊治方法。方法对23例确诊为桡神经深支旋后肌卡压综合征的患者,根据具体病情分别采取旋后肌腱弓切开减压术和变形桡神经段切除、断端显微修复缝合术。回顾性分析患者的临床资料。结果 23例患者均顺利完成手术,术后均获3~5个月随访,22例患者桡神经深支功能恢复正常。切开旋后肌腱弓减压的3例患者中,1例患者手功能恢复不满意,尚需进一步手术治疗。结论桡神经深支旋后肌卡压综合征可根据临床症状、体征和电生理检查明确诊断。一旦诊断成立,即应手术治疗,术后桡神经深支功能恢复较好。  相似文献   

8.
目的 探讨帕金森叠加综合征(PPS)相关疾病的临床诊断思路.方法 回顾性分析2005年1月至2011年12月住院的52例PPS患者的临床资料,并依据PPS相关疾病的诊断标准作出临床诊断.结果 本组52例患者的出院诊断是:多系统萎缩(MSA) 19例、进行性核上性麻痹(PSP) 12例、Wilson病(WD)7例、路易体痴呆(DLB)6例、阿尔茨海默病(AD)伴帕金森综合征(PS)6例和皮质基底节变性(CBD)2例.结论 PPS相关疾病间,虽然临床症状有较多相似之处,但各个疾病的临床特征、诊断标准及治疗转归各不相同,正确区分十分必要.提高认识、理清概念、把握特征,是正确诊断的基础.通过采集详细可靠的病史,发现特异性体征和特征性影像学改变,检测铜篮蛋白,以及判断L-dopa 试验反应性,是鉴别诊断的有效手段.  相似文献   

9.
目的 探讨抗Hu抗体检测在神经系统副肿瘤综合征诊断中的临床意义.方法 采用间接免疫荧光方法和蛋白免疫印迹法对送检至北京协和医院神经病理实验室的1500余例患者的血清和脑脊液进行抗Hu抗体检测,回顾性分析抗Hu抗体阳性患者的临床资料及诊断.神经系统副肿瘤综合征的诊断标准参照Graus等的诊断标准.结果 共有27例患者抗体阳性,其中血清抗Hu抗体阳性25例,脑脊液抗Hu抗体阳性8例.临床主要表现为感觉神经元神经病、亚急性小脑变性、Lambert-Eaton综合征和抗利尿激素分泌不当综合征引起的脑病等,其中20例(74.1%)患有肿瘤,包括肺癌17例,胃癌2例,不明性质腹部肿瘤1例.7例患者未发现恶性肿瘤,包括多发性肌炎和系统性红斑狼疮(SLE)合并神经肌肉病各1例.根据Graus等神经系统副肿瘤综合征的诊断标准,27例中22例可确诊神经系统副肿瘤综合征或相关的肿瘤,抗Hu抗体的阳性预测值为81.5%.结论 抗Hu抗体阳性对神经系统副肿瘤综合征的诊断具有一定意义;其相关肿瘤以肺癌,特别是小细胞肺癌最常见.其他自身免疫性疾病偶可见抗Hu抗体阳性,需要全面检查和密切随访以排除恶性肿瘤的可能.  相似文献   

10.
目的 探讨自身抗体对副肿瘤综合征的诊断价值。方法 利用间接免疫荧光法对 48例疑诊副肿瘤综合征患者进行抗 Yo抗体、抗 Hu抗体、抗 Ri抗体测定和临床随访 ,并与正常人和神经系统其他疾病患者对照。结果  48例中 ,1例病前有肺癌史 ,2例检查中发现肿瘤 ,4例随访 3~ 1 8个月后发现肿瘤。正常对照组和神经系统其他疾病组自身抗体均为阴性 ,患者组中有 1例呈副肿瘤性脑脊髓炎 ,其抗 Hu抗体阳性 ,相对分子质量为3 80 0 0 ,病理检查证实为小细胞肺癌。结论 自身抗体测定对此病的早期诊断有一定价值 ,但阳性率不高 ,其临床价值尚需进一步随访证实  相似文献   

11.
Introduction: We investigated whether muscle ultrasound can distinguish muscles affected by post‐polio syndrome (PPS) from healthy muscles and whether severity of ultrasound abnormalities is associated with muscle strength. Methods: Echo intensity, muscle thickness, and isometric strength of the quadriceps muscles were measured in 48 patients with PPS and 12 healthy controls. Results: Patients with PPS had significantly higher echo intensity and lower muscle thickness than healthy controls. In patients, both echo intensity and muscle thickness were associated independently with muscle strength. A combined measure of echo intensity and muscle thickness was more strongly related to muscle strength than either parameter alone. Conclusions: Quantitative ultrasound distinguishes healthy muscles from those affected by PPS, and measures of muscle quality and quantity are associated with muscle strength. Hence, ultrasound could be a useful tool for assessing disease severity and monitoring changes resulting from disease progression or clinical intervention in patients with PPS. Muscle Nerve 51 : 24–29, 2015  相似文献   

12.
Post-polio syndrome (PPS) is characterized by new muscle weakness, atrophy, fatigue and pain developing several years after the acute polio. Some studies suggest an ongoing inflammation in the spinal cord in these patients. From this perspective, intravenous immunoglobulin (IvIg) could be a therapeutic option. We performed a double-blinded randomized controlled pilot study with 20 patients to investigate the possible clinical effects of IvIg in PPS. Twenty patients were randomized to either IvIg 2 g/kg body weight or placebo. Primary endpoints were changes in pain, fatigue and muscle strength 3 months after treatment. Surrogate endpoints were changes in cerebrospinal fluid (CSF) cytokine levels. Secondary endpoints were pain, fatigue and isometric muscle strength after 6 months. Patients receiving IvIg reported a significant improvement in pain during the first 3 months, but no change was noted for subjective fatigue and muscle strength. CSF levels of tumour necrosis factor- α (TNF- α ) were increased compared with patients with non-inflammatory neurological disorders. In conclusion, in this small pilot study no effect was seen with IvIg treatment on muscle strength and fatigue, however IvIg treated PPS patients reported significantly less pain 3 months after treatment. TNF- α was increased in the CSF from PPS patients. The results are promising, but not conclusive because of the low number of patients studied.  相似文献   

13.
Elevated serum inflammatory markers in post-poliomyelitis syndrome   总被引:1,自引:0,他引:1  
OBJECTIVES: To determine (i) whether serum inflammatory markers TNFalpha, IL-1beta. IL-6, and leptin are increased in post-poliomyelitis syndrome (PPS) compared to healthy controls; and (ii) whether an association exists between elevated inflammatory markers and clinical parameters in PPS. The cause of PPS is unknown, but abnormal inflammatory responses have been implicated in several small studies. METHODS: Serum inflammatory markers were measured (by Luminex) in 51 PPS patients and 26 normal controls. Clinical parameters assessed included disease duration, muscle strength (Medical Research Council sumscore), fatigue (Fatigue Severity Scale and Multidimensional Fatigue Inventory), and pain (visual analog scale scores). RESULTS: In PPS, TNFalpha levels, as well as IL-6 and leptin were significantly increased compared to controls (Wilcoxon rank-sum test, p=0.03 for TNFalpha, p=0.03 for IL-6, p=0.01 for leptin). The elevated TNFalpha levels in PPS were associated with increased pain due to illness (Spearman correlation coefficient r=0.36, 95% C.I. 0.09 to 0.57) and specifically, with muscle pain (r=0.38, 95% C.I. 0.11 to 0.59). There were no correlations between inflammatory markers in PPS and joint pain, muscle strength, fatigue, or disease duration. CONCLUSIONS: Serum TNFalpha, IL-6 and leptin levels are abnormally increased in PPS patients. Elevated TNFalpha levels appear to be specifically associated with increased muscle pain.  相似文献   

14.
Post-polio syndrome (PPS) is a clinical syndrome of new weakness, fatigue and musculoskeletal pain occurring in a variable proportion of polio survivors decades after acute disease. To date, several risk factors for PPS development have been reported, although the etiology of this disorder remains elusive. Using a case–control design, we aimed to assess risk indicators for PPS in a group of Italian polio survivors. Subjects with prior poliomyelitis attending the rehabilitation hospital of Malcesine, Italy, were the target population. Patients with PPS, diagnosed according to the European Federation of Neurological Societies criteria, served as cases, while patients not meeting diagnostic criteria for PPS were used as controls. All subjects were assessed through a structured questionnaire made of 82 questions and neurological examination. The association with investigated risk factors (sex, age at polio onset, age at onset of symptoms, extension and severity of polio, employment) was analyzed by the calculation of the odds ratio. A total of 161 out of 391 eligible patients met the adopted diagnostic criteria for PPS, giving a frequency of 41.2%. Symptoms most frequently complained by PPS patients were loss of muscle strength, loss of resistance, loss of muscle volume and generalized fatigue. Female gender, the presence of respiratory disturbance during the acute phase of polio and the use of orthoses and aids during the recovery and stabilization represented independent risk factors for PPS in the studied population.  相似文献   

15.
The outcome of paralytic polio was believed to be a stable neurological state. Now, it is established that polio has an additional, slowly progressive phase, called post-polio syndrome (PPS) that develops 30–40 years after the acute poliomyelitis in 25–80% of paralytic and about 40% of nonparalytic polio survivors. The clinical symptoms are nonspecific and usually include muscle weakness, fatigue and muscle or joint pain. Some patients suffer from muscular atrophy, respiratory insufficiency, dysphagia, sleep disturbances or cold intolerance. The etiopathogenesis of PPS is unclear and many factors, such as dysfunction of the surviving motor units, aging, defects of neuromuscular transmission, persistence of viral infection and immunological mechanisms, are considered. This article reviews the epidemiology, pathophysiology, clinical characteristics and diagnosis of PPS patients.  相似文献   

16.
17.
The present study investigated whether intrinsic fatigability of the muscle fibers is reduced in patients with post-polio syndrome (PPS). This may contribute to the muscle fatigue complaints reported by patients with PPS. For this purpose, we assessed contractile properties and fatigue resistance of the knee extensor muscles using repeated isometric electrically evoked contractions in 38 patients with PPS and 19 age-matched healthy subjects. To determine whether any difference in fatigue resistance between both groups could be attributed to differences in aerobic capacity of the muscle fibers, 9 patients with PPS and 11 healthy subjects performed the same protocol under arterial occlusion. Results showed that fatigue resistance of patients with PPS was comparable to that in controls, both in the situation with intact circulation and with occluded blood flow. Together, our findings suggest that there are no differences in contractile properties and aerobic muscle capacity that may account for the increased muscle fatigue perceived in PPS.  相似文献   

18.
Introduction: Reports from non‐Asian populations indicate that painful physical symptoms are associated with poorer clinical and functional outcomes in patients with Major Depressive Disorder (MDD). This paper shows the changes in disease characteristics and quality of life in Taiwanese MDD patients, with or without painful physical symptoms, over 3 months' observation. Methods: Taiwanese patients from an observational study of six East Asian countries/regions were classified as painful physical symptom positive (PPS+) or negative (PPS−) based on a mean score of ≥2 or <2, respectively, on the modified Somatic Symptom Inventory. Changes from baseline in outcomes were compared between the groups. Results: Of 194 patients with MDD, 69% were PPS+ at baseline. These PPS+ patients were more depressed (17‐item Hamilton Depression Rating Scale total; mean [SD] 27.1 [6.26] versus 21.8 [5.94] PPS−, P<0.001), in more pain (Visual Analog Scale overall; median [range] 73.5 [9–100] versus 40 [0 to 80] PPS−, P<0.001) and had poorer quality of life at baseline (EuroQoL; mean [SD] 42.9 [18.26] versus 59.8 [18.21] PPS−,P<0.001). At endpoint (n=118), PPS− patients showed greater improvement on depression outcomes (Clinical Global Impression of Severity; P=0.011) and had a higher remission rate (52.8 % versus 14.6% PPS+, P=0.007). Discussion: Painful physical symptoms were frequently observed in Taiwanese patients with MDD. As PPS are associated with more severe depression, poorer quality of life, and poorer remission outcomes, clinical management should address both the mental and physical symptoms associated with this disorder.  相似文献   

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