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神經影像(九十五)Leigh症候群

摘要


Leigh症候群(Leigh syndrome, LS)為粒線體疾病(mitochondrial disease)之一,為粒線體呼吸鏈(mitochondrial respiratory chain)異常的遺傳性疾病。臨床上以漸進性的神經學表現為主,如發展遲緩、癲癇、意識改變、呼吸衰竭等;此外,也可能出現身材矮小、多毛症(hypertrichosis)、肝功能異常等症狀。磁振造影(magnetic resonance imaging, MRI)為最重要的影像診斷工具,可以在T2加權(T2-weighted)及液體衰減反轉恢復序列(fluid attenuated inversion recovery, FLAIR)影像中,看到殼核(putamen)及中腦導水管周圍灰質(periaqueductal gray matter, PAG)的對稱性高訊號表現。Leigh症候群的發生率約為四萬分之一,患者多在兩歲前發病。臨床上以支持性治療為主,預後不佳,許多患者在發病數個月後過世。

參考文獻


Finsterer J. Leigh and Leigh-like syndrome in children and adults. Pediatr Neurol 2008;39:223-35.
Lee HF, Tsai CR, Chi CS, et al. Leigh syndrome: clinical and neuroimaging follow-up. Pediatr Neurol 2009;40:88-93.
Rahman S, Blok RB, Dahl HH, et al. Leigh syndrome: clinical features and biochemical and DNA abnormalities. Ann Neurol 1996;39:343-51.
Baertling F, Rodenburg RJ, Schaper J, et al. A guide to diagnosis and treatment of Leigh syndrome. J Neurol Neurosurg Psychiatry. 2014;85 :257-65.
Friedman SD, Shaw DW, Ishak G, et al. The use of neuroimaging in the diagnosis of mitochondrial disease. Dev Disabil Res Rev 2010;16:129-35.

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