可逆性后部白质脑病综合征临床分析

目的探讨可逆性后部白质脑病综合征的临床表现和神经影像学检查特点。方法回顾性分析9例可逆性后部白质脑病综合征患者的发病原因、临床症状、影像学检查特点、治疗及预后。结果9例患者中,男5例、女4例,起病原因多样,其中子痫2例,高血压脑病4例(2例肾脏疾病,1例原发性高血压,1例继发于干燥综合征),系统性红斑狼疮1例,肾移植后给予环孢素治疗1例,肺癌术后行化疗1例。临床表现多样,主要为头痛、抽搐、视觉异常和意识丧失等。头颅MRI检查均有以半球后部白质为主的T1加权低信号及T2加权或液体衰减反转恢复(FLAIR)序列呈高信号的病灶,且大多双侧对称。经对因及适当的脱水治疗,患者症状基本缓解。结论可逆性后部白质脑病综合征是一种有特征临床和影像学检查表现的临床综合征。及时就诊、尽早治疗后,一般预后良好。

Reversible posterior leukoencephalopathy syndrome: a clinical analysis

Objective To summarize the clinical and MRI features of reversible posterior leukoencephalopa- thy syndrome(RPLS).Methods The etiology,clinical manifestations,MRI features,treatment and prognosis of 9 patients with RPLS were retrospectively analyzed.Results The 9 patients included 5 males and 4 females and they had various etiologies.Among them 2 patients had eclampsia,4 had hypertensive encepalopathy(2 associated with renal disease,1 with primary hypertension,and 1 was secondary to sjogren syndrome),1 had systemic lupus erythematosus,1 had taken cyclosporine after renal transplantation,and 1 was receiving chemotherapy after opera- tion of lung cancer.The clinical manifestations of patients included headaches,seizures,visual abnormalities and loss of consciousness.MRI of head mainly showed white brain abnormalities(in most cases bilaterally symmetric) in the posterior regions of the brain.After treated by heteropathy and dehydraiton therapy,the neurological deficits of the patients almost resolved.Conclusion RPLS is a clinical syndrome with distinctive clinical and neruoradiolo- gica[ manifestations.Its prognosis is good if the correct diagnosis is made at its early stage and the treatment is promptly given.