结核性脑膜脑炎并发结核性脊髓神经根炎的临床特点1例报道

目的总结结核性脑膜脑炎并发结核性脊髓神经根炎病例的临床特点。方法对国内文献报道的结核性脑膜脑炎并发结核性脊髓神经根炎病例的临床资料进行回顾总结。结果患者均为中青年,首发症状为头痛、发热、脑膜刺激征等,逐渐出现截瘫、大小便障碍、传导束型感觉障碍等脊髓受累表现,脑脊液检查提示初压高,蛋白、细胞数增多,糖降低,磁共振提示颅内及脊髓病灶伴脑脊髓膜强化,抗结核药物联合激素治疗有效。结论结核性脑膜脑炎患者出现脊髓病变症状体征,需警惕并发结核性脊髓神经根炎,脑脊液结果及增强磁共振有助于诊断。

Clinical characteristics of tuberculous radiculomyelitis complicated tuberculous meningocephalitis:report of 1 case

Objective To summarize the clinical characteristics of tuberculous radiculomyelitis complicatied tuberculous meningocephalitis.Methods The clinical data of the patients with tuberculous radiculomyelitis complicated tuberculous meningocephalitis in China since 2000 were analyzed retrospectively.Results All the 6 cases were young or mid-aged,initial symptom was headache,febrile,meningeal irritation sign,etc.Spinal cord symptoms ensued such as paraplegia,bladder and bowel disturbance,hypoesthesia.The abnormalities of cerebrospinal fluid(CSF) were elevation of initial pressure and protein,pleocytosis,hypoglycorrhachia.Magnetic resonance imaging(MRI) revealed abnormal focus in intracranial and spinal cord with enhancement of meninges.Treatment with antituberculosis drugs and glucocorticoid were effective.Conclusion When a patient with tuberculous menigocephalitis develops spinal cord symptoms,tuberculous radiculomylitis should be suspected.CSF and MRI are necessary for diagnosis.