46例Wernicke脑病的临床、影像学、治疗及预后

The Clinical Performance,Imaging Feature,Treatment and Prognosis of Wernicke Cerebropathy with 46 Cases

目的探讨Wernicke脑病的病因、临床表现特点、MRI表现及预后。方法对46例Wernicke脑病患者的病因、发病机制、临床表现、头颅MRI特点和预后进行了回顾性分析。结果 Wernicke脑病病因多与维生素B1缺乏有关,慢性酒精中毒仍是其主要病因(本组占56.5%),临床经典三联征少见,易漏诊、误诊,主要临床表现为眼肌麻痹,共济失调、精神异常三联征,但也可以表现为周围神经病、言语障碍等。头颅MRI有特异性部位的异常信号改变。及时予以维生素B1治疗者预后多良好。结论提高临床对Wer-nicke脑病的认识,有利于早诊断、早干预,有助于改善Wernicke脑病的预后。

Objective To discuss the Wernicke encephalopathic cause of disease,the clinical manifestation,the MRI performance and the prognosis.Methods The etiology,pathogenesis,clinical manifestations,brain MRI characteristics and prognosis of 46 cases Wernicke cerebropathy were analyzed retrospectively.Results The most cause of wernicke cerebropathy might lacks with vitamin B1 deficiency,the chronic alcoholism was still a main cause of disease（this group accounts for 56.5%）,The classical triad rarely and easy misdiagnoses.The main clinical manifestations is triple disease of ophthalmoplegia,ataxia and psychosis,but can also be expressed as peripheral neuropathy,speech disorders.Head MRI has the specificity spot unusual signal changes.Vitamin B1 therapy patients in a timely was more favorable prognosis.Conclusion To Improve the clinical understanding is conducive to early diagnosis,early intervention,help to improve the prognosis of Wernicke encephalopathy.