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患儿,男性,3.5岁,平素健康,否认遗传病史,骨髓涂片确诊为急性淋巴细胞性白血病(ALL)。以强的松60mg/m~2/日,柔红霉素40mg/m~2/周iv,长春新碱(VCR)2mg/m~2/周iv及氨甲蝶呤12mg/m~2/周鞘内注射治疗,2周后咳嗽,发热,4周后出现头痛,肢体疼痛及感觉异常,遂发展为四肢瘫痪,呼吸肌麻痹,需呼吸机维持。无感觉和颅神经受损。肝酶正常,脑脊液蛋白由正常增至1.3g/L,并持续数周,无细胞,糖正常,脑电图正常,电神经描记显示正常的感觉传导速度,但肌反应缺乏,肌电图未显示自主运动和阳性尖波或纤颤。瘫痪后即停用VCR,6周后停用呼吸机,18月后上肢瘫痪缓慢恢
Children, men, 3.5 years old, usually healthy, deny genetic history, bone marrow smear diagnosis of acute lymphoblastic leukemia (ALL). The patients were treated with prednisone 60 mg / m 2 / day, daunorubicin 40 mg / m 2 / week iv, vincristine 2 mg / m 2 / week iv and methotrexate 12 mg / Week intrathecal injection treatment, 2 weeks after cough, fever, headache after 4 weeks, limb pain and sensory abnormalities, then developed into quadriplegia, respiratory muscle paralysis, the need for ventilator maintenance. No sensation and cranial nerve damage. Normal liver enzymes, cerebrospinal fluid protein from normal to 1.3g / L, and continued for several weeks, no cells, normal glucose, normal EEG, electromyogram showed normal sensory conduction velocity, but the lack of muscle response, EMG is not Show autonomous motility and positive spikes or fibrillation. Disable VCR after paralysis, disable ventilator after 6 weeks, paralysis of upper limb slowly after 18 months