有机溶剂致中毒性脑病5例分析

5 cases analysis of toxic encephalopathy induced by organic solvents

目的探讨工作环境接触有机溶剂致中毒性脑病患者的临床表现及影像学特点。方法回顾性分析5例在工作环境中接触有机溶剂致中毒性脑病患者临床表现及CT和MRI资料。结果所有患者均有有机溶剂接触史;临床表现以头晕、恶心呕吐、记忆力下降、走路不稳为主要特征;CT均表现为双侧对称边界清楚的低密度病灶,无占位效应。头部MRI表现为双侧对称性长T1长T2信号,Flair呈高信号,增强无强化。结论结合工作环境毒物接触史、中枢神经症状,及CT和MRI表现,可诊断有机溶剂中毒性脑病。

Objective To study the clinical manifestations and imaging features of toxic encephalopathy induced by organic solvents. Methods Five patients with toxic encephalopathy induced by organic solvents were observed and ana- lyzed with clinical manifestation and MRI or CT imaging. Results All patients presented with subacute onset and with a history of direct exposure to organic solvents. The whole brain injury symptoms were the main neurological manifestations, such as headache,nausea,vomiting and ataxia. CT showed symmetric low density, MRI examination showed low signal in T1 WI and high signal in T2 WI in bilateral hemispheric white matter, cerebellar dental nucleus and globus pallidus. After the treatment of dehydrating agent, glucocorticoid and supportive treatment, the status of five patients were improved. Conclu- sion The clinical manifestation and MRI or CT imaging are helpful to the diagnosis of toxic encephalopathy induced by or- ganic solvents. The early and long term use of glucocorticoids and dehydrating agent are key for the poisoning patients.