Necrotizing Encephalitis with Paraplegia -A Case Report

壞死性腦炎合併雙下肢癱瘓－病例報告

林宙晴(Chou-Ching Lin) ； 蔡子同(Tzu-Tung Tsai)

《慈濟醫學雜誌》 11卷2期 (1999/06) Pp. 197-202

https://doi.org/10.6440/TZUCMJ.199906.0197

摘要

本文報告一急性發作癲癇、發燒、意識改變和下肢癱瘓之病例。在整個病程中，首先出現兩次癲癇大發作、發燒和意識改變，然後出現尿失禁和下肢癱瘓合併反射降低。一個月後，症狀完全恢復。腦部核磁共振攝影呈現類似單純泡疹性腦炎的變化，但是下肢癱瘓和脊髓液聚合酵素鏈反應對單純泡疹病毒呈陰性結果顯示急性傳播性腦脊髓炎為較可能之診斷。文中將回顧文獻探討此類疾病診斷之困難性。

關鍵字

腦炎 ； 下肢癱瘓 ； 單純泡疹病毒

並列摘要

A case of acute onset of seizures, fever, change of consciousness and paraplegia was reported. The episode began with two attacks of generalized tonic-clonic seizures, fever and consciousness disturbance, followed by urinary incontinence and paraplegia with hyporeflexia. Magnetic resonance imaging of the brain gave a picture mimicking herpes simplex encephalitis. However, subsequent paraplegia and the negative result of polymerase chain reaction (PCR) in cerebrospinal fluid favors the diagnosis of acute disseminated encephalomyelitis. The patient recovered completely in one and half months later. The difficulty in diagnosing this category of diseases will be discussed with literature review.

並列關鍵字

encephalitis ； paraplegia ； herpes simplex virus