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目的:探讨以癫痫首发钩端螺旋体(钩体)脑动脉炎发病机理和防治。方法:对102例患者临床表现、实验检查,并复习文献。结果:102例中,钩体L型脑动脉炎43例,有肢体瘫痪80例,共济失调7例;血清钩体MAT阳性72例,CSF钩体MAT阳性17例;体液培养:原形钩体31例,L型钩体45例;EEG异常94例;颅CT:示颅内单发或多发低密度灶44例;颅MRA:3例中有2例颅底异常血管网征,1例颅内动脉粗细不均,1侧大脑中动脉不显影。结论:钩体脑动脉炎的发生可能为钩体或钩体L型直接损伤神经组织或供血血管,甲硝哒唑疗效显著,并可减少钩体病后发症
Objective: To investigate the pathogenesis and prevention of cerebral arteritis in the first episode of seizures. Methods: The clinical manifestations of 102 patients, the experimental examination, and review the literature. Results: In 102 cases, 43 cases of L-type cerebral arteritis had limb paralysis with 80 cases of ataxia, 7 cases of ataxia, 72 cases of MAT positive serogroups and MAT positive of CSF hookages 17 cases. Humoral culture: 31 cases, 45 cases of L-shaped hook body, 94 cases of EEG abnormalities, Cranial CT showed 44 cases of intracranial single or multiple low-density lesions, 3 cases of cranial MRA: 2 cases of skull base abnormal vascular network sign, 1 case of skull Uneven internal artery thickness, 1 side of the middle cerebral artery does not develop. Conclusions: The incidence of LASIK may be caused by L-type injury or blood supply to the L-shaped hooks or leptospirosis. Metronidazole has a significant effect and can reduce the post-L-disease complications