亚洲女童视网膜炎合并多发性硬化1例(英文)

Optic neuritis with multiple sclerosis in a 10-year-old Asian girl

目的:报道亚洲儿童单侧视神经炎合并多发性硬化1例方法:病例报道结果:中国女孩10岁,右眼视力突然持续下降3d,伴有眼球运动痛。患者1a前曾有高热并伴有步态共济失调病史。当时被诊断为急性弥散性脑脊髓炎,右眼视力数指,伴有瞳孔传入阻滞,视盘充血水肿,色觉功能受损严重。视野检查显示中心暗点及盲点扩大。脑部磁共振MRI结果显示大脑左侧枕叶有较高密度影损害,神经中枢基部和脑室周围的区域提示多发性硬化。给予患者甲基强的松龙静脉滴注3d,以后改为口服强的松龙11d。患者出现明显好转,视力提高到6/9,并且维持3a没有复发结论:视神经炎合并多发性硬化在儿童中比较罕见且鲜有报道。我们报道这个病例就是为了强调这个疾病在亚洲青少年人群出现的可能性。

AIM： To report a case of unilateral optic neuritis with multiple sclerosis in an Asian child . METHODS： A case report . RESULTS： A 10-year-old Chinese girl presented with history of sudden loss of vision of the right eye for 3 days, duration. It was associated with pain in eye movement. She gave history of fever associated with ataxic gait a year ago. She had been diagnosed to have acute disseminated encephalomyelitis （ADEM）. Visual acuity in the right eye was ‘counting finger＇ with positive afferent pupillary defect. The optic disc was swollen and hyperemic. The colour vision was severely impaired. Visual field showed central scotoma and enlarged blind spot. Magnetic resonance imaging （MRI） of the brain revealed multiple intense lesions in the left occipital lobe, basal ganglia and periventricular regions suggesting multiple sclerosis. She was treated with intravenous methylprednisolone for 3 days, followed by oral prednisolone for 11 days. She had excellent recovery and her visual acuity improved to 6/9. She remained asymptomatic for 3 years. CONCLUSION： The simultaneous occurrence of optic neuritis and multiple sclerosis is less common in children and seldom reported. We presented this case to highlight the possibility of this disease occurring in Asian population in a younger age group.