带状疱疹致多根脑神经损害的诊治分析

目的分析带状疱疹相关多根脑神经损害的临床特征，并结合文献分析其发病机制。方法回顾性分析21例颜面部带状疱疹合并多根脑神经损害患者的临床资料，并结合相关文献资料分析总结。结果21例患者中男9例，女12例；平均年龄（55．10±8．66）岁，均急性起病，所有患者均伴随有不同程度的多根脑神经损害症状和体征，最多累及5根脑神经，最少累及2根脑神经，其中1例患者伴发脑病表现，头颅MRI发现双侧额叶沿脑沟分布边缘不清的异常长T1、长T2信号，所有患者均在抗病毒、糖皮质激素、B族维生素营养神经、甘露醇脱水降颅压治疗后好转。结论有多根脑神经损害的患者需要注意头面部皮疹，排查是否有带状疱疹感染，及时查脑脊液，及时足量抗病毒对症处理，避免疾病进展。

Objective To analyze the clinical features of herpes zoster-associated multiple cranial nerve injuries and to analyze the pathogenesis. Methods The clinical data of 21 patients with herpes zoster complicated with cranial nerve lesion were analyzed retrospectively, combined with the relevant literature analysis summary. Results 21 patients （ 12 males and 9 females ） , mean age was （ 55.10 ± 8.66 ） years, all had acute exacerbation. All patients were accompanied by varying degrees of multiple cranial nerve injury, 2-5 cranial nerves were injured. One of patients had encephalopathy, and his head MRI found that the bilateral frontal lobe had abnormal long T1, long T2 signal. All patients were improved after the treatment of antiviral, glucocorticoid, B vitamins, neurotrophic, mannitol. Conelusion Patients with multiple cranial nerve injury should to be paid attention to head and face rash, excluding herpes zoster infection caused, to check lumbar puncture in time and adequate anti-viral treatment can avoid disease progression.