副肿瘤性小脑变性临床分析

The Clinical Analysis of Para-Neoplastic Cerebellar Degeneration

目的分析副肿瘤性小脑变性患者的临床特点。方法回顾性分析13例副肿瘤性小脑变性患者的起病方式、临床表现、相关检查结果、肿瘤来源、误诊情况、治疗效果、愈后等临床资料。结果临床诊断小脑病变,应考虑到副肿瘤性小脑变性;原发肿瘤以小细胞肺癌、肠癌、乳腺癌、卵巢癌、何杰金病等多见;明确原发肿瘤病灶后,行原发肿瘤综合治疗后,小脑症状有明显改善。结论临床如遇成年、小脑症状、突然起病、进行性加重、不符合原发神经病变规律,排除小脑卒中、感染、肿瘤、中毒性小脑病变、遗传性小脑变性等,应考虑到副肿瘤性小脑变性,需行全身详细的体检及影像学检查,避免原发灶的漏诊,早期明确诊断为及时治疗提供条件。

Objective To explore the clinical characteristics of the patients of abstrparaneoplastic cerebellar degeneration. Methods Clinical records of 13 cases with abstrparaneoplastic cerebellar degeneration were retrospectively reviewed for the mode of onset, clinical feature, relevant findings, tumour sourse, misdiagnose case, therapeutic effect and prognosis. Results Ab- strparaneoplastic cerebellar degeneration should be taken into consideration when establish the clinical diagnosis of cerebellum disease. The primary tumor origins were predominant in lung, ovarian, breast, and Hodgkin＇ s lymphoma. If the diagnosis of the primary tumor was definite and the comprehensive treatment of the tumour should be taken, the cerebellar symptoms will be im- proved obviously. Conclusion In clinic, if the acute cerebellar disease occurred in the adult and grown progressively, which didn＇ t conform to the primary neuropathic symptoms, we should consider the disease of abstrparaneoplastic cerebellar degenera- tion when these diseases such as cerebellum stroke, infection, tumour, toxic cerebe[[ar lesion, hereditary cerebellar degeneration had been excluded. In order to clarify a diagnosis on the early stage and take treatment in time, it was necessary to avoid the mis- diagnosis of the primary tumour by careful physical examination and imageological diagnosis.