匹克威克综合征和阻塞性睡眠呼吸暂停综合征相关性假性脑瘤

目的:报告1例男性患者合并有匹克威克综合征和阻塞性睡眠呼吸暂停(OSA),其临床表现为假性脑瘤和视力下降。方法:病例报告。结果:患者,男,54岁,过度肥胖,诉双眼视力渐降3mo,检查示:视力:右眼20/200,左眼20/400,左眼合并色觉异常,眼底镜示双视乳头水肿和视盘旁出血,左眼合并黄斑部渗出。体格检查和实验室检查符合阻塞性睡眠呼吸暂停与匹克威克综合征诊断。腰椎穿刺:开放压350mmHg,脑部扫描正常。诊断:OSA和匹克威克综合征相关性假性脑瘤。眼底表现和视力随采血治疗、血压控制、体重控制及双层正压通气治疗而改善。结论:对于患有假性脑瘤的患者,必须对阻塞性睡眠呼吸暂停与匹克威克综合征有所警惕。

Pseudotumor cerebri associated with Pickwickian syndrome and obstructive sleep apnea syndrome:a case report

AIM:To report a male patient with Pickwickian syndrome and obstructive sleep apnea(OSA) who presented with pseudotumor cerebri and visual loss. METHODS:Case report.RESULES:A 54-year-old obese man with a three-month history of bilateral visual deterioration was evaluated. His visual acuity was 20/200 in OD and 20/400 in OS. Color vision was impaired only in the left eye. Funduscopy revealed bilateral disc edema and peripapillary hemorrhages together with macular exudates in OS. Physical examination and laboratory investigations were consistent with OSA and Pickwickian syndrome. Lumbar puncture demonstrated an opening pressure of 350mm H2O and computed brain scan was normal. The diagnosis was pseudotumor cerebri in association with OSA and Pickwickian syndrome. Fundus findings and visual acuity improved with phlebotomy, blood pressure regulation, weight reduction and bi-level positive airway pressure therapy. CONCLUSION:OSA and Pickwickian syndrome should be kept in mind when facing a patient with pseudotumor cerebri.