可逆性后部白质脑病综合征1例报告并文献复习

Case report of posterior reversible encephalopathy syndrome with literature review

目的探讨可逆性后部白质脑病的常见病因、发病机制、临床表现、诊断及治疗措施。方法对1例产褥期可逆性后部白质脑病综合征患者的诊疗经过进行分析。结果患者有中枢神经系统症状、体征,结合相关检查结果,采用脱水、营养神经、对症支持治疗,预后良好。结论可逆性后部白质脑病综合征是一种由多种原因引起的以神经系统异常为主要表现的临床综合征。常见的病因有恶性高血压、妊娠子痫、各类严重肾脏疾病、免疫抑制剂及细胞毒药物、自身免疫病的治疗等。急性或亚急性起病,临床表现多种多样,常见的有头痛、痫性发作、视觉障碍、意识障碍及精神异常等。临床诊断主要依据其典型的影像学改变,大多数影像学改变为可逆性,预后良好。

Objective To investigate the common etiology ,mechanism ,clinical manifestation ,diagnosis and therapeutic options of the posterior reversible encephalopathy syndrome （PRES）.Methods One PRES patient in puerperium with an onset of neurological manifestation was retrospectively reviewed.Results The patient with CNS symptoms and signs has good prog‐nosis after dehydration therapy.Conclusion PRES is a clinical syndrome caused by many reasons ,its main clinical manifesta‐tion is abnormal CNS.The common etiology includes malignant hypertension ,eclampsia ,all kinds of serious kidney disease , immunosuppressive drugs ,cytotoxic drugs ,and the treatment of autoimmune diseases and so on.Its form of onset is acute or subacute.It is varied from clinical manifestation.And the most common are headache ,seizures ,visual impairment ,conscious impairment and insanity.Clinical diagnosis is mainly based on the typical radiographic changes.Most imaging changes are re‐versible and can be disappear after 2 weeks or longer.It has a good prognosis after treatment.