左旋咪唑所致脑病患者的临床资料分析

目的研究左旋咪唑致脱髓鞘脑病患者的临床、CT与MRI的特点.方法分析36例左旋咪唑所致脱髓鞘脑病的临床、CT与MRI资料.结果左旋咪唑所致脱髓鞘脑病的主要临床表现为急性或亚急性起病的弥漫性脑损害,尤以早期的精神症状(77.8%)和神经障碍(91.7%)突出,皮质激素治疗效果好,36例患者的CT和MRI检查异常率分别为89%和100%,CT异常以低密度灶为主(81%),且大多数累及额、顶、颞、枕叶及侧脑室等白质区,MRI异常多为双侧脑室周围及额、顶、枕、颞叶白质区和基底节等处,呈多发、散在的长T1和长T2异常信号灶,T2加权像显示敏感,两种检查占位效应均不明显.结论该病的诊断依据其临床特点和影像学检查,CT和MRI检查对该病的鉴别诊断、治疗及预后均有较高的价值.

Clinical study on levamisole induced demyelinating encephaiopathy

Objective To study the clinical,CT and MRI features of levamisole induced demyelinating encephalopathy(LIDE). Methods The clinical, CT and MRI dates were analysed in 36 patients with LIDE. Results The main clinical manifestations of the disease were acute or subacute diffuse cerebral lesions, especially for early mental symptoms( 77.8%) and nerve weakness( 91.7%),the patients had good therapeutic effect to corticosteroids.The abnormal rates of CT and MRI in cases were 89% and 100%.The main abnormality of CT was low density areas and most of the pathology were scattered in the frontal, parietal,occipital,temporal and periventricular, etc, as in white matter areas.The MRI of 36 cases showed multiple lesions scattered in the periventricular, frontal, parietal, occipital and temporal areas. The lesions were long T 1 and T 2-abnormal signls,T 2-weighted images were highly sensitive to the lesions, Mass effect was few shown in the two exams.Conclusion The diagnosis of LIDE depended on the clinical features and neuroradiological appearance, CT and MRI are valuable for the distinction, treatment and anticipation in LIDE patients.