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25例多系统萎缩(MSA)病例中,橄揽桥脑小脑萎缩(OPCA)15例,Shy-Drager 综合征(SDS)8例,纹状体黑质变性(SND)2例。临床发现每型早期各有特点,OPCA 以共济失调为主,SDS 以植物神经症状为主,SND 以帕金森综合征为主。症状叠加时出现次序不同,确诊时间不同。磁共振成像(MRI)显示 OPCA、SDS 主要为小脑脑干萎缩,可有壳核信号异常;SND 则主要为壳核 T_2加权像高信号。脑干听觉诱发电位(BAEP)可发现 MSA 的隐匿病灶,确定可疑病灶,异常率76%。临床、MRI、BAEP 三者结合可提高 MSA 的早期诊断率。
In 25 patients with multiple system atrophy (MSA), there were 15 cases of OPCA, 8 cases of Shy-Drager syndrome (SDS) and 2 cases of striatum degeneration of the substantia nigra (SND). Clinical manifestations of each type of early each have their own characteristics, OPCA mainly ataxia, SDS to autonomic symptoms, SND to Parkinson’s disease-based. Symptoms superimposed appear in different order, diagnosis time is different. Magnetic resonance imaging (MRI) showed that OPCA and SDS were mainly atrophy of cerebellum and brain stem, and had abnormality of putamen signal. SND was mainly signal of T_2 weighted image of putamen. Brainstem auditory evoked potentials (BAEP) can detect MSA occult lesions identified suspicious lesions, the abnormal rate of 76%. Clinical, MRI, BAEP combination of three can improve the early diagnosis of MSA.