脱髓鞘疾病51例

Clinical Analysis on 51 Cases of Children with Demyelinating Disease

目的分析小儿脱髓鞘疾病的临床特点,以提高对该疾病的诊断与治疗。方法对51例小儿脱髓鞘疾病的发病年龄、前驱症状、临床表现及辅助检查特点等进行回顾性分析。结果51例脱髓鞘疾病患儿中学龄期38例,有前驱感染史32例,疫苗接种史3例,大多以急性起病。周围神经脱髓鞘疾病32例以双下肢或四肢瘫痪为首发;中枢神经脱髓鞘疾病以视力障碍、肢体无力、发热、抽搐、头痛等为首发。周围神经脱髓鞘疾病患儿中15例行肌电图检查,均显示为神经源性改变;18例中枢神经脱髓鞘疾病患儿中17例行CT或MRI,均发现异常信号。结论小儿脱髓鞘疾病的临床表现复杂多变,通过病史及辅助检查,进行综合分析,不难得出诊断,预后良好。

Objective To study the clinical characteristics of children with demyelinating disease. Methods Age of onset, presymptoms, clinical manifestations and auxiliary examinations of 51 children diagnosed as demyelinating disease were analyzed retrospectively. Results The onset age was from 3 months to 14 years, and the number of school age children was 38. Before illness,32 cases were relevant to infection,3 cases to vaccine inoculation. Most of children had acute courses. In the initial stage,32 cases with peripheral nervous demyelinating disease presented to paralysis of limbs; 18 cases with central nervous demyelinating disease presented to visual disorder, somatasthenia, fever, convulsion and headache. The EMGs of children with peripheral nervous demyelinating disease showed nervous lesion. Among 18 children with central nervous demyelinating disease, 17 cases showed abnomal signal on MRI or CT. Conclusions Children with demyelinating disease displays diversified clinical manifestations. By investigating case history combined with auxiliary exaninations, it is not difficult to make a correct diagnosis and its prognosis is good commonly.