头痛、左侧肢体无力7个月伴智能减退1.5个月
摘要
1临床资料患者女,35岁,因“头痛、左侧肢体无力7个月伴智能减退1.5个月”于2008—04入院。患者于2007—09中旬出现头痛,右眶额部持续胀痛渐加重伴视物模糊,并出现左侧肢体无力、麻木,步态不稳。头颅MRI提示颅内大面积占位,于10-19行开颅手术,病理报告为“炎症”,未治疗。11月初头痛及左侧肢体无力加重,伴阵发性四肢颤动,予甲泼尼龙治疗,起始剂量1000mg/d,半量递减,减量至2008—01下旬病情未见明显缓解,予大剂量青霉素治疗近两周(具体剂量不详)。2008-02初发生脑疝,行去骨瓣减压术并再次活检,病理报告仍为“炎症”,停用青霉素,改为复方新诺明0.96g/d,口服。术后左侧肢体及右下肢无力,
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2014年第2期145-149,共5页
Chinese Journal of Neuroimmunology and Neurology
参考文献9
-
1Whipple GH. A hitherto undescribed disease characterized an atomically by deposits of fat and farty acids in the intestinal and mesenteric lymphatic tissues[J]. Johns Hopkins Med Bu11,1907,98:382-391.
-
2Mohamed W, Nell E, Kupsky WJ, et al. Isolated intracranial Whippleis disease report of a rare case and review of the lit- erature[J]. J Neurol Sci,2011,308:1-8.
-
3Fenollar F, Puechal X, Raouh D. Whipple's disease[J]. N Engl J Meal, 2007,356:55- 56.
-
4de Andrade DC, Nogueira RC, Lucato LT,et al. Isolated CNS Whipple disease with a variant of oculofacial-skeletal myo- rhythrrfia (OFSM) [J]. Neurology, 2007,69 : E12.
-
5Louis ED, Lynch T, Kaufmann P, et al. Diagnostic guidelines in central nervous system Whipple's disease[J]. Ann Neurol,1996, 40:561 -568. S.
-
6ung VW, Lyerly MJ, Fallon KB, et al. Isolated CNS Whip- ple disease with normal brain MRI and false-positive CSF 14 3- 3 protein: a case report and review of the literature[J]. Brain Behav, 2012,2:838- 843.
-
7Xavier Puechal. Whipple's disease[J]. Ann Rheum Dis, 2013,72 : 797-803.
-
8Nelson JW, White ML, Zhang Y,et al. Proton magnetic reso nance spectrosopy and diffusion weighted imaging of central nervous system Whipple disease[J]. J Comput Assist To mogr, 2005,29 : 320-322.
-
9Feurle GE, Junga NS, Marth T. Efficacy of ceftriaxone or meropenem as initial therapies in Whipple's disease[J]. Gas troenterology, 2010, 138: 478-486.
-
1王真真,王镇涛,陈文明.Whipple病[J].临床荟萃,2003,18(9):533-534. 被引量:2
-
2张良兵,徐磊,蔡永亮.神经系统Whipple病[J].中国全科医学,2007,10(23):2016-2018.
-
3乔金辉,朱洪升,王建堂,张玉江.复方新诺明致急性肌张力障碍1例[J].中国实用内科杂志,1995,15(11):651-651. 被引量:4
-
4杨润华,鞠娟.抗炎治疗对脑出血破入侧脑室患者认知功能的影响[J].黑龙江医学,2006,30(7):521-522.
-
5张敏.奥扎格雷钠注射液治疗缺血性脑血管病86例[J].社区医学杂志,2005,3(8):71-72.
-
6王向波.[19]癫痫发作7个月,智能减退5个月,视力下降、听力减退3个月(下)--神经系统Whipple病[J].中国神经精神疾病杂志,2010,36(11):700-704. 被引量:1
-
7刁晓君,陈春富.神经系统Whipple病1例并文献复习[J].山东大学学报(医学版),2015,53(10):46-50.
-
8张君.复方新诺明致过敏性紫癜1例[J].医学美学美容(中旬刊),2012(12):136-136.
-
9张欢,郭晨诗,商秀丽.中耳炎合并静脉窦血栓及肥厚性硬脑膜炎临床及分析一例[J].中华临床医师杂志(电子版),2013,7(13):211-212. 被引量:3
-
10李玉荣,万东君,付学锋.吉兰-巴雷综合征误诊为急性脑梗死1例[J].中国误诊学杂志,2011,11(10):2345-2345.