结核性脊髓脊膜炎5例临床分析

目的提高对结核性脊髓脊膜炎的认识,减少误诊率。方法回顾性分析5例结核性脊髓脊膜炎的病例资料。结果结核性脊髓脊膜炎的临床表现为脊髓不完全性损害,病变水平以下肢体瘫痪,感觉障碍、括约肌功能障碍、神经根痛等。髓内受累时MRI可表现为脊髓肿胀、结核瘤,脊膜蛛网膜受累时,表现为腰段神经根增厚,蛛网膜下腔消失,腰穿椎管通畅或部分梗阻,脑脊液提示结核性改变。早期易误诊为前列腺肥大、椎间盘突出症、脊髓蛛网膜炎等。抗结核治疗病情可明显缓解。结论结核性脊髓脊膜炎表现多样,MRI无特异性,CSF为结核性改变,临床误诊率高,须引起临床医师重视。

Objective To raise the awareness of tuberculous meningitis spinal cord and reduce the rate of misdiagnosis. Methods A retrospective analysis the information of 5 cases of tuberculous meningitis spinal cord. Results The outcome of tuberculous meningitis spinal cord clinical performance for the incomplete spinal cord injury, paralysis of limbs below the level of disease, sensory disturbance, the sphincter dysfunction, nerve root pain, and so on. Intramedullary performance can be affected when the MRI swelling to the spinal cord, tuberculoma, spinal arachnoid involvement, for the performance of the lumbar nerve root thickening, subarachnoid disappeared lumbar spinal canal or open part of the obstruction, cerebrospinal fluid prompted to change Tubercular. Early misdiagnosed as benign prostatic hypertrophy, disc herniation, spinal arachnoid go far. Results Anti-TB treatment can significantly ease the condition.