论文部分内容阅读
1992-1994年我院收治儿童多发性硬化症9例,男3例,女6例;1-3岁4例,-7岁3例,-12岁2例。确诊年龄1岁半-12岁。急性起病7例,亚急性l例,慢性1例。视力障碍3例,视神经萎缩1例,中枢性面瘫2例。吞咽困难1例,反呛、构音障碍2例.偏瘫3例,听力障碍1例,阵发性抽搐4例。其中3例为全身发作。头痛、眩晕2例。腱反射亢进4例,巴彬斯基征阳性6例。脑脊液检查5例白细胞>10×10~6/L,4例蛋白>400mg/L,3例IgG>40mg/L,。脑电图仅1例轻度异常。7例头部CT检查2例表现脑白质区内低密度灶。9例MRI检查全部阳性,多在大脑皮层下、顶叶、枕叶、视放射、两侧脑室旁、脑干可见斑点状、斑片状长T_1长T_2异常信号。2例有V—R间隙增多。本症是中枢神经系统以白质受累为主的炎性脱髓鞘疾病。目前多认为它属于自身免疫性疾病,多见于10-50岁,我国儿童较多见,近年陆续有报告。本文10岁以下者7例。临床表现多种多样,主要特点即症状的反复发作和病灶的多发。本组以视力障碍、阵发性抽搐、锥体束征为常见。典型病例诊断不难,但需与视神经炎、病毒性脑炎、癜痫相鉴别。对早期诊断及不典型病例诊断较困难,头部CT、核磁共振、脑电图、诱发电位、脑脊液检查有助诊断。本病治疗无特效疗法,本组采用肾上腺皮质激素、低能量He—Ne激光血管内照射疗法?
From 1992 to 1994, 9 cases of multiple sclerosis in children were treated in our hospital. There were 3 males and 6 females, 4 in 1-3 years, 3 in -7 years and 2 in -12 years. The diagnosis of age 1 year and a half -12 years old. Acute onset in 7 cases, subacute l cases, chronic in 1 case. 3 cases of visual impairment, 1 case of optic nerve atrophy, 2 cases of central facial paralysis. Dysphagia in 1 case, anti-choke, dysarthria in 2 cases, hemiplegia in 3 cases, hearing impairment in 1 case, paroxysmal convulsions in 4 cases. Three of them were generalized. Headache, dizziness in 2 cases. Tendon hyperreflexia in 4 cases, Babinski sign positive in 6 cases. 5 cases of cerebrospinal fluid leukocyte> 10 × 10 ~ 6 / L, 4 cases of protein> 400mg / L, 3 cases of IgG> 40mg / L ,. EEG only 1 case of mild abnormalities. Two cases of head CT scan showed low density lesions in white matter area. Nine cases of MRI examination were all positive, mostly in the cerebral cortex, parietal lobe, occipital lobe, depending on the radiation, both sides of the ventricle, brain stem spots can be spotted, patchy T_1 long T_2 abnormal signal. 2 cases of V-R gap increased. The disease is the central nervous system white matter-based inflammatory demyelinating disease. At present, many think it belongs to autoimmune diseases, more common in 10-50 years of age, more common in our children, one after another in recent years have been reported. This article is under the age of 10 in 7 cases. A variety of clinical manifestations, the main features of recurrent symptoms and multiple lesions. This group of visual impairment, paroxysmal convulsions, pyramidal tract signs are common. Typical case diagnosis is not difficult, but with optic neuritis, viral encephalitis, epilepsy phase identification. Diagnosis of early diagnosis and atypical cases more difficult to diagnose head CT, MRI, EEG, evoked potentials, cerebrospinal fluid can help diagnose. The treatment of disease-free therapies, the group of adrenal cortex hormones, low-energy He-Ne laser intravascular irradiation therapy?