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目的总结成人轻度脑炎或脑病伴可逆性胼胝体压部病变(mild encephalitis/encephalopathy with a reversible splenial lesion,MERS)患者的临床特点。方法回顾性分析6例MERS患者的临床资料,总结MERS的临床特征。结果 6例MERS患者中,5例以精神行为异常为首发症状,5例伴发热,出现反应迟钝、记忆力下降、一过性意识障碍、谵妄各2例,合并头痛、嗜睡各1例;3例存在定向障碍,2例脑膜刺激征阳性;脑脊液检查均无明显异常;头颅MRI均可见胼胝体压部异常信号;经治疗后,1个月内患者症状及影像学改变消失。结论当患者有脑炎或脑病症状且头颅MRI示胼胝体压部有异常信号时,需高度警惕MERS,定期复查头颅MRI有助于MERS的诊断;治疗后颅内病变可逆者预后良好。
Objective To summarize the clinical features of mild encephalitis / encephalopathy with a reversible splenial lesion (MERS) in adult patients with mild encephalitis or encephalopathy. Methods The clinical data of 6 MERS patients were retrospectively analyzed. The clinical features of MERS were summarized. Results Among the 6 MERS patients, 5 patients had psychiatric abnormalities as their first symptom, 5 patients had fever, and they had unresponsiveness, memory loss, transient disturbance of consciousness, and delirium in 2 cases, each with headache and drowsiness in 1 case; 3 cases There were disorientation and 2 cases of positive meningeal irritation. There was no obvious abnormality in cerebrospinal fluid examination. Abnormal signals of the corpus callosum were observed in all the patients with head MRI. The symptoms and imaging changes disappeared in 1 month after treatment. Conclusion When patients with encephalitis or encephalopathy symptoms and cranial MRI showed abnormal signals of the corpus callosum pressure, the need to be highly vigilant MERS, regular review of the head MRI is helpful in the diagnosis of MERS; prognosis of intracranial lesions after treatment is good prognosis.