亚急性联合变性不典型性三例分析

目的探讨不典型亚急性联合变性患者临床与影像学表现,以及避免误诊的临床体会。方法分析3例不典型亚急性联合变性患者的临床表现和辅助检查资料,探讨其临床表现及早期误诊经过。结果3例患者不典型表现分别为治疗期间出现的激素副作用导致的"中心性浆液性脉络膜视网膜病变"、腰膨大病变与髓内病灶。结论不典型亚急性联合变性,临床表现多样,突出且持续的后索损害及症状体征的选择性、对称性是本病特点,对其认识不足是造成早期误诊原因。

Analysis of 3 atypical cases of subacute combined degeneration

Objective To explore the cilinical and radiological presentation of subacute combined degeneration(SCD). Method We retrospectively studied 3 cases of hospitalized patients with SCD. Their clinical information and results of associated tests were collected. Then we tried to discuss the causes of misdiagnosis in the early stage.Results The atypical presentation of the 3 cases were: one with central serous chorioretinopathy(CSC) during steroid therapy; one with intumescentia lumbalis lesion; and one with huge intramedullary lesion.Conclusions The diagnosis criteria for SCD has not been well published. Symptoms of SCD may vary, but prominent and consistent signs of posterior columns disorder, the selectivity and symmetrical characteristic of the symptoms and signs are the key points of making the diagnosis.