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亚急性脊髓混合变性的17例临床特征和诊断
引用本文:夏斌,邵福源,赵忠新.亚急性脊髓混合变性的17例临床特征和诊断[J].中华神经科杂志,1998,31(1):13.
作者姓名:夏斌  邵福源  赵忠新
作者单位:第二军医大学长征医院神经科
摘    要:目的评价亚急性脊髓混合变性(SCD)的临床特征及电生理和磁共振成像的诊断价值。方法回顾分析了17例SCD患者的临床表现。结果发现全部SCD患者发病由维生素B12缺乏引起,胃大部切除术是一个主要病因,肢体感觉异常和深感觉减退是SCD最常见的症状和体征,12例合并周围神经损害,5例合并植物神经损害,体感诱发电位有极高的敏感性,磁共振成像可以明确脱髓鞘的部位。结论电生理和磁共振检查对SCD的诊断和治疗起重要作用

关 键 词:亚急性脊髓混合变性  维生素B_(12)缺乏  诱发电位  磁共振成像

The clinical characteristic and diagnosis of 17 cases subacute combined degeneration
Xia Bin,Shao Fuyuan,Zhao Zhongxin,et al..The clinical characteristic and diagnosis of 17 cases subacute combined degeneration[J].Chinese Journal of Neurology,1998,31(1):13.
Authors:Xia Bin  Shao Fuyuan  Zhao Zhongxin  
Institution:Xia Bin,Shao Fuyuan,Zhao Zhongxin,et al. Department of Neurology,Changzheng Hospital,Shanghai 200003
Abstract:Objective To evaluate the clinical characteristic of subacute combined degeneration and diagnostic values of electrophysiologic examinations and magnetic resonance imaging. Methods A retrospective analysis of 17 cases of subacute combined degeneration was presented. Results The results showed that the middle and old aged men were predominant and gastrectomy was a main cause. Parasthesias of the limbs and diminished vibration and position sensations were the most commonest symptoms and signs. All of the patients were caused by vitamin B 12 deficiency, 12 cases were accompanied by peripheral nerve injury, 5 cases autonomic nerve injury. Nerve conduction velocity showed that the peripheral nerve injury was likely to be due to demyelination. Somatosensory evoked potentials had extremely high sensitivity so that all the patient had some abnormal sties, among which the recorded waves not appear in 8 cases. Magnetic resonance imaging showed compatible evidence of demyelination changes in the spinal cords with T 2 weighted images of abnormally high signals in the posterior columns. Conclusion The examinations of electrophysiology and magnetic resonance imaging could play an importment role in the diagnosis and treatment of subacute combined degeneration.
Keywords:Subacute combined degeneration    Vitamin  B    12  deficiency        Somatosensory evoked potential        Magnetic resonance imaging  
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