急性氟乙酰胺中毒性脑病6例临床及影像学分析

目的探讨氟乙酰胺中毒性脑病的神经系统临床表现及影像学特点,以提高对本病认识。方法回顾性分析2006年3月~2012年10月在中国医科大学附属盛京医院急诊科诊断氟乙酰胺中毒性脑病患者6例的临床表现及颅脑磁共振(MRI)特点。结果男4例、女2例口服氟乙酰胺后出现头痛、抽搐及其他神经系统表现。颅脑磁共振表现为皮层及皮层下白质弥漫性对称分布的细胞毒性水肿性病变。经过治疗6例患者临床症状部分或全部缓解。6例患者在6~10 d后复查头颅CT(2例)或MRI(4例)显示病灶完全消失。结论本病诊断主要依靠病史及典型临床表现,影像学缺乏特异性,但头颅MRI表现能对早期诊断提供参考。早期诊断及治疗患者预后良好。

Clinical manifestations and cerebral MRI appearances of acute toxic encephalopathy of fluoroacetamide

Objective To investigate the clinical manifestations and cerebral MRI appearances of toxic encephalopathy of fluoroacetamide.Methods 6 cases of toxic encephalopathy of fluoroacetamide from March 2006 to October 2011 diagnosed in the Sheng Jing Hospital Affiliated of China Medical University were collected and their clinical manifestations and cerebral MRI appearances were retrospectively analyzed.Results 6 patients（4 male and 2 female） manifested headache,epilepsy and other neurological appearances after fluoroacetamide intoxication.Cerebral MRI showed cerebral cortex and cerebral cortex alba diffused symmetrical cellular edema.All patients＇clinical manifestations were partially or totally resolved after timely treatment.All cases reviewed cerebral CT（two patients）/MRI（four patients） showed normal after 6-10 days.Conclusions The diagnosis of toxic encephalopathy induced by fluoroacetamide depends mainly on the clear toxicant contact history,clinical features.Characteristics of neuroimaging are Lack of specificity.Central nervous MRI can provide a reliable basis for early diagnosis.The prognosis are satisfying if earlier diagnosis and treatment.