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目的 :提高对散发性婴幼儿脑型脚气病早期诊治的认识。方法 :记述 1 2例婴幼儿脑型脚气病的临床表现 ,实验室检查 ,治疗及随访情况。结果 :1 2例均以精神异常改变为首发症状 ,继而出现不同程度的声音嘶哑等喉返神经麻痹症状 ,8例有肢体瘫痪。 1 2例作头颅 CT检查 ,1 1例示两侧基底节对称性变性改变 ,另 1例头颅 CT正常者 ,作头颅 MRI示 T2 W呈两侧基底节对称性片状高信号。及时试用维生素 B1治疗 ,上述表现在一周内明显好转。结论 :对有急性精神异常改变的婴幼儿 ,须尽早作头颅 CT或 MRI检查 ,两侧基底节区对称性变性改变 ,是本病早期诊断的重要特征。及时给予维生素 B1治疗 ,预后良好 ,也是本病早期诊断的依据。
OBJECTIVE: To raise awareness of early diagnosis and treatment of brain beriberi in sporadic infants and young children. Methods: Describe the clinical manifestations, laboratory tests, treatment and follow-up of 12 cases of infantile brain beriberi. Results: All 12 patients were changed to mental disorder as the first symptom, followed by varying degrees of hoarseness and other recurrent laryngeal nerve paralysis symptoms, limb paralysis in 8 cases. 1 2 cases of head CT examination, 11 cases showed bilateral symmetry of the basal ganglia degeneration change, and the other 1 cases of normal skull CT, head MRI showed T2W showed basal ganglion symmetry Flake high signal. Time trial of vitamin B1 treatment, the performance was significantly improved within a week. Conclusion: Infants and young children with acute mental abnormalities should be examined by skull CT or MRI as early as possible. The symmetry of the basal ganglia degeneration on both sides is an important feature of early diagnosis of this disease. Timely treatment of vitamin B1, the prognosis is good, but also the basis for the early diagnosis of the disease.