进行性核上性眼肌麻痹的诊断与鉴别诊断及病例分析

Diagnosis and different diagnosis of progressive supranuclear palsy and case study

目的在临床病例分析和文献复习的基础上,加深对进行性核上性眼肌麻痹(PSP)的认识,提高诊断水平。方法结合文献对1例PSP病例进行详细分析,总结经验教训。结果 PSP临床具有明显的异质性,有的缺乏典型临床表现,常被误诊为脑血管病、椎间盘突出等。根据头颅磁共振成像中脑萎缩呈"蜂鸟征"特征性的改变,可以做出PSP的临床诊断。结论加深对PSP的典型及非特异性临床表现的认识,特别要重视老年人的腿脚不灵活、乏力等非特异性的临床表现,结合头磁共振成像的动态改变,可以提高PSP的临床诊断率。

Objective Based on the literature view about progressive supranuelear palsy （PSP） and analysis of clinical case, deepen the understanding of the disease and improve the diagnostic level. Methods Combined with literature for example of PSP case in detail analysis, summarizes the experience and lessons. Results PSP has obvious clinical heterogeneity, some lack of typical clinical manifestations, is often misdiagnosed as cerebrovascular disease, disc herniation, etc. According to MRI ＂hummingbird＂ characteristic, can make diagnosis of PSP. Conclu- sion Deepen the understanding of the typical and nonspecific clinical manifestations of PSP, especially noticed the legs and feet of the elderly not flexible, fatigue . Combined with the MRI dynamic change, can improve the clinical diagnostic rate of PSP.