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目的探讨渗透性脱髓鞘综合征的临床及神经影像学特点。方法分析1例渗透性脱髓鞘综合征患者的临床特点,包括起病前诱因、临床表现、头颅MRI特点、治疗及预后情况。结果患者有长期大量饮酒史,以意识改变、四肢瘫痪、肌张力障碍等为临床表现,血钠及CSF正常。头颅MRI表现为右侧额叶、颞叶、皮质、双侧枕叶、双侧基底节、丘脑、脑干及小脑多发病灶,T1WI加权低信号、T2WI加权高信号,头颅MRI增强扫描可见明显强化。预后差,呈持续浅昏迷状态。结论渗透性脱髓鞘综合征与长期大量饮酒有关,可以没有低钠血症,临床具有双相病程。头颅MRI显示病变可累及皮质,增强扫描可见明显强化。
Objective To investigate the clinical and neuroimaging characteristics of osmotic demyelinating syndrome. Methods The clinical features of one patient with osmotic demyelinating syndrome were analyzed, including the predisposition, clinical manifestations, features of cranial MRI, treatment and prognosis. Results Patients had a long history of heavy drinking, with the change of consciousness, quadriplegia, dystonia and other clinical manifestations, serum sodium and CSF were normal. Head MRI showed right frontal lobe, temporal lobe, cortex, bilateral occipital lobe, bilateral basal ganglia, thalamus, brainstem and cerebellum multiple lesions, T1WI-weighted low signal, T2WI-weighted high signal, MRI enhanced MRI showed significant enhancement . Poor prognosis, showing persistent shallow coma state. Conclusion Permeable demyelinating syndrome is associated with long-term heavy drinking, which can be devoid of hyponatremia and has a biphasic clinical course. Head MRI showed lesions can affect the cortex, enhanced scan showed significant enhancement.