脑干脑炎11例的临床特点及MRI表现

Clinical features and magnetic resonance imaging of brain encephalitis in 11 cases

目的探讨脑干脑炎(brainstem encephalitis,BSE)的临床特点、头部MRI表现。方法回顾分析11例BSE患者的临床资料。结果 11例中急性起病5例,亚急性起病6例,发病前有上呼吸道感染史4例,临床表现脑神经损害7例,锥体束征8例,小脑征3例,感觉长束征3例。脑脊液检查,细胞数升高4例,蛋白含量升高7例。头部MRI检查病灶位于桥脑10例,中脑3例,延髓2例。经皮质类固醇激素、抗病毒等治疗后患者均明显好转,随访近1年,未复发。结论 BSE多急性起病,临床表现多样,脑脊液检查异常,头部MRI病灶多位于桥脑,病程多为单相,多数患者预后良好。

Objective To explore the clinical features and magnetic resonance imaging of brainstem encephalitis （BSE）. Methods The clinical data of 11 patients with BSE were summarized. Results Among the enrolled patients, 5 cases were acute, and 6 cases were subacute onset. Four cases had the history of upper respiratory tract infections before the onset of the disease. Seven cases had multiple cranial nerves disfunetion, 8 cases had pyramidal sign, 3 cases had cerebellum sign. Three cases had sign of spinothalamic tract. Cerebrospinal fluid showed abnormal leueocytosis in 4 cases and abnormal el- evation of protein in 7 cases. On head MRI, the lesion was located in pons in 10 cases, midbrain in 3 cases, medulla in 2 cases. All cases were obviously improved after treatment with corticosteroid and antivirus. All cases did not relapse in fol- low-up 1 year. Conclusion Most patient of brainstem encephalitis have acute onset, complex clinical manifestation, abnor- mal eerebrospinal fluid. Lesions of head MRI in patient are located in ports mostly. The course of BSE is monophasic most- ly, and the prognoses of most BSE patients are good.