急性播散性脑脊髓炎的临床特征和转归

目的:探讨急性播散性脑脊髓炎的临床特征、临床治疗及转归。方法:对3例急性播散性脑脊髓炎患者的临床表现及相关辅助检查结果进行详细分析,并对其治疗后的情况进行随访。结果:3例患者均为中年,急性起病,脑和脊髓损害的表现重叠出现,有脑脊液及影像学检查的改变,在急性期采用甲基强的松龙冲击治疗,结合神经营养及支持治疗,均好转。结论:急性播散性脑脊髓膜炎临床表现多样,是神经内科临床较易误诊及漏诊的疾病,早期诊断后激素治疗效果良好,可使其预后大大改善。

Clinical Characteristics and Prognosis of Acute Disseminated Encephalomyelitis

Objective:Clinical characteristics,effectiveness of treatment and prognosis of acute disseminated encephalomyelitis(ADEM) have been retrospectively assessed.Methods: Three patients who were diagnosed to have suffered ADEM in Tongji Hospital were retrospectively analyzed clinically.Results: The 3 patients were affected by this disease in their middle ages.The onsets were acute,presenting the manifestations of both impaired cerebral and spinal cord functions in the same period.The changes of cerebral spinal fluid and CT/MRI were suggestive.The 3 patients have been treated with pulsed infusion of methylprednisolone,and other neuroprotective and supportive drugs.All the 3 patients improved significantly.Conclusion: The clinical presentation of ADEM is complicated,so the disease is very likely to be mistaken for other diseases. The early recognition and prompt initiation of pulsed infusion of methylprednisolone constitute the prerequisite of satisfactory prognosis.