Acute Disseminated Encephalomyelitis in Children: Clinical, Neuroimaging and Neurophysiologic Studies

兒童急性瀰漫性腦脊髓炎：臨床、神經影像及神經生理學檢查的研究

李旺祚(Wang-Tso Lee) ； 王本榮(Pen-Jung Wang) ； 廖漢文(Hon-Man Liu) ； 楊千立(Chaingllie Young) ； 曾兆麟(Chao-Lin Tseng) ； 張楊全(Yang-Chyuan Chang) ； 沈友仁(Yu-Zen Shen) ； 李慶雲(Chin-Yun Lee)

《Acta Paediatrica Sinica》 37卷3期 (1996/06) Pp. 197-203

https://doi.org/10.7097/APS.199606.0197

摘要

從1988年6月至1995年12月間，在本院共有9個病人罹患急性瀰漫性腦炎髓炎並接受核磁共振(MRI)的檢查。他們分別爲4個月至20歲大(平均年齡8.6歲)。其中7個(78%)病人分別接授了腦波、誘發、電位、神經傳導及F波的測定。其主要的初期臨床症狀爲頭痛、嘔吐、意識改變及肢體無力。其中7個(78%)病人在發病之前有發燒或上呼吸道感染，1個曾接受疫苗的注射，另1個則找不到明確的前置因素。腦部核磁共振檢查的異常主要在腦幹(n=6)，基底核(n=5)，視丘(n=4)，腦室週邊白質(n=4)和小腦(n=4)。接受誘發電位檢查的病人都可顯顯示出脊髓的病變。另有1介病人有週邊神經病變；而腦部核磁共振檢查和神經生理檢查在急性瀰漫性腦脊髓炎的診斷上，則具有互補的功能。

關鍵字

急性瀰漫性腦脊髓炎 ； 誘發電位

並列摘要

Nine patients below 20 years of age (4 males and 5 females), who were diagnosed to have acute disseminated encephalomyelitis (ADEM) by clinical findings and magnetic resonance imaging (MRI), were reviewed retrospectively. They ranged from 4 months to 20 years of age with an average of 8.6 years. Seven patients (78%) received neurophysiological studies, which included electroencephalography, multimodality evoked potentials (EPs), nerve conduction velocity and/or F-wave measurement. The presentation symptoms were mainly headache, vomiting, consciousness change and motor deficits. Seven (78%) of nine patients had symptoms preceded by fever or upper respiratory tract infections; one (11%) was preceded by trivalent mumps, measles, rubella vaccination and no definite predisposing factor was found in another. Computed tomography (CT) scans were abnormal in five (71%) of seven children, while MRI showed multiple lesions in seven (78%) of nine children. The lesions in MRI were mainly in the brainstem (n=6), basal ganglion (n5), thalamus (n=4), periventricular white matter (n=4) and cerebellum (n=4). EPs disclosed spinal cord involvement in all patients who received the examination. Peripheral neuropathy was disclosed in one patient. It was concluded that associated radiculoneuropathy is possible in patients with ADEM. Both MRI and neurophysiologic studies are complementary for diagnosis of ADEM.

並列關鍵字

acute disseminated encephalomyelitis ； evoked potential ； magnetic resonance imaging