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目的探讨急性小脑性共济失调(ACA)的早期诊断和治疗方法。方法回顾性分析2003年6月-2008年9月本院收治的11例ACA患儿的临床资料。11例均予常规抗感染治疗,有颅高压等症状者予对症处理,排除结核后使用激素治疗,症状较轻者口服泼尼松片1～2周,逐渐减量至停药;较重者静脉予甲泼尼龙15～20 mg.kg-1.d-1冲击,连用3 d后改泼尼松片口服序贯治疗,1周后逐渐减量至停药。结果11例ACA患儿均临床治愈,3～15 d症状消失,平均住院9.5 d。出院后随访0.5 a,患儿症状均无复发,未见后遗症出现。结论小儿ACA的病因以感染多见,尽早发现行走不稳等共济失调表现及进行神经系统检查有助于早期诊断,一般预后良好,极少遗留后遗症。
Objective To investigate the early diagnosis and treatment of acute cerebellar ataxia (ACA). Methods The clinical data of 11 children with ACA admitted to our hospital from June 2003 to September 2008 were retrospectively analyzed. 11 cases were routine anti-infective treatment, symptoms such as intracranial hypertension symptomatic treatment, excluding tuberculosis after the use of hormone therapy, mild symptoms of oral prednisone tablets for 1 to 2 weeks, tapering to withdrawal; heavier Intravenous to methylprednisolone 15 ~ 20 mg.kg-1.d-1 impact, continuous use of 3 days after the change of prednisone tablets oral sequential treatment, 1 week after the gradual reduction to withdrawal. Results All 11 cases of ACA were cured clinically, symptoms disappeared after 3 ~ 15 days, and the average hospitalization was 9.5 days. Follow-up after discharge 0.5 a, no recurrence of symptoms in children, no sequelae appeared. Conclusion The etiology of pediatric ACA is more common with infection. Early detection of ataxia, such as unstable walking, and neurological examination are helpful for early diagnosis. The general prognosis is good with minimal sequelae.