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颞动脉炎(TA)是一种几乎能影响到身体任何动脉的系统性血管炎症。与TA 伴发的一系列综合征包括冠状动脉炎,肺部疾患,心包炎,心肌炎及肾、肝的并发症。TA 的中枢神经系统表现有视觉障碍,短暂缺血发作,脑梗塞,精神错乱及意识水平降低。本文介绍一例TA 患者发生昏迷,并伴有EEG 三相波,用类固醇治愈。患者男,76岁。因突然发生昏迷入院。六个月前,头痛及弥散性肌痛,几周后突发面瘫,有贫血,血沉>100mm/小时,面诊断为TA。经类固醇治疗临床症状完全消失。用药期间出现妄想及抑郁,将类固醇减量以至停用。类固醇停用后2个月,病情恶化突然发生昏迷而再次入院,仅能对伤害性刺激做出无目的手动反应。脉搏,体温正常,血压160/100mmHg,无神经系统定位体征。实验室各项化验(除血沉50mm/小时外)均无特殊改变(包括脑脊液、
Temporal arteritis (TA) is a systemic vascular inflammation that affects almost any body’s arteries. A series of syndromes associated with TA include coronary artery disease, pulmonary disease, pericarditis, myocarditis, and complications of kidney and liver. Central nervous system manifestations of TA are visual disturbances, transient ischemic attacks, cerebral infarction, confusion and decreased levels of consciousness. This article describes a case of coma TA patients, accompanied by EEG three-phase wave, cured with steroids. Male patient, 76 years old. Due to a sudden coma admission. Six months ago, headache and disseminated myalgia, sudden facial paralysis after a few weeks, anemia, erythrocyte sedimentation rate> 100mm / hour, surface diagnosis of TA. Steroid treatment of clinical symptoms completely disappeared. Delusions and depression during treatment, steroid reduction and even disabled. Two months after the steroid was discontinued, the patient suddenly became unconscious and re-admitted to hospital with a deteriorating condition, making a purposeless manual response to noxious stimuli. Pulse, normal body temperature, blood pressure 160 / 100mmHg, no signs of nervous system positioning. Laboratory tests (except ESR 50mm / hour outside) no special changes (including cerebrospinal fluid,