病毒性脑炎伴精神行为异常41例临床分析

Viral encephalitis with mental and behavior disorder:clinicalanalysis of 41 cases

目的:探讨精神行为异常为首发症状的病毒性脑炎的临床特点,以期早期诊断和治疗。方法:对精神行为异常为首发症状的41例病毒性脑炎的临床表现,脑脊液、脑电图和神经影像学资料进行回顾性分析。结果:呈急性或亚急性发病,主要早期表现为精神行为异常,伴有智能减退、发热、头痛、癫痫发作和意识障碍。常规脑脊液检查异常率43.9%,早期脑电图检查异常率92.7%,脑MRI检查异常率51.2%。结论:精神行为异常可以是病毒性脑炎的首发症状,常伴有智能减退、癫痫发作和意识障碍,结合脑电图、脑脊液、MRI和CT检查可以作出早期诊断和治疗。

Objective： To investigate the clinical characteristics of 41 cases with viral encephalitis with mental and behavior disorder as initial manifestations, and to assist the early diagnosis and treatment. Methods： The data of clinical manifestations, cerebrospinalfluid （CSF） , electroencephalography （EEG） , neuroimaging findings in 41 cases was analyzed retrospectively. Results： Onset manner of viral encephalitis was acute or subacute. The most common early manifestations were mental and behavior disorder, anoesia, fever, headache, epilepsy and disturbance of consciousness. Routine CSF examination showed the abnor- malities in 43.9%. Routine early EEG examination showed the abnormalities in 92.7%. CT showed the ab- normalities in 51.2%. Conclusion： Mental and behavior disorder may be the first symptoms of viral en- cephalitis, often accompanied by anoesia, epilepsy and disturbance of consciousness. Early diagnosis and treatment can be established based on EEG,CSF,MRI and CT.