急性播散性脑脊髓炎8例临床分析

目的研究急性播散性脑脊髓炎(ADEM)的临床特点。方法对8例临床确诊为ADEM患者进行回顾及随访,并对临床和影像学表现等进行分析。结果(1)临床表现:5例病前有前驱感染或疫苗接种史,3例无明显诱因,神经系统症状多样。(2)影像学表现:主要累及脑白质的脱髓鞘病变,4例累及丘脑,2例累及脊髓。(3)治疗及预后:8例全用激素,其中7例予甲基泼尼松龙冲击。4例同时合用人血丙种球蛋白。8例均经6个月～2年随访,无复发,其中3例遗留后遗症。结论ADEM是一种中枢神经系统炎性脱髓鞘疾病,临床表现多样。MRI表现有一定的特征性,MRI检查有利于早期诊断,也是评价疗效的重要手段。

Clinical analysis of acute 8 disseminated encephalomyelitis

Objective To study the clinical features of acute disseminated encephalomyelitis(ADEM).Methods A retrospectively analysis and follow-up study were conducted in 8 patients with the diagnosis of ADEM to summarize the characteristics of clinical and imaging features etc.Results(1)Clinical manifestations :herald infections and vaccine inoculations were fod in 5 patients.No forerunner was found in another 3 patients.Various symptoms of central nervous system occurred one by one or simultaneously in the illness process.(2)Imaging manifestations:Brain albe was involved mainly in demyelinating diseases.The thalamencephalons of 4 patients were involved.Spinal cords of 2 patients were involved.(3)Treatments and prognosisses :All patients were administ hormone High dose methylprednisolone was administ in 7 patients.4 patients received intravenous immunoglobulin.All patients showed good response and were taken follow-up from 6 months to 2 years.No recurrence occurred in them.3 patients of them had longterm neurologic sequelae.Conclusion ADEM was a phlegogenic demyelinating disease with multiple clincal manifestations in central nervous system.Some determined marks were founded in MRI test.It was an important method for early diagnosis and evaluating therapeutic effect.