可逆性胼胝体压部病变综合征6例临床分析

Clinical analysis of 6 cases of reversible corpus callosum compression syndrome

目的分析儿童可逆性胼胝体压部病变综合征(RESLES)的临床表现、MRI资料及随访结果,总结其MRI特点。方法收集我院神经科收治RESLES患儿6例纳入为研究对象,记录患儿的临床表现,采用头颅MRI检查,分析RESLES患儿的临床疗效及随访结果。结果 6例患儿经头颅MRI检查显示RESLES-Ⅰ型5例,表现为胼胝体压部圆形病灶;RESLES-Ⅱ型1例,表现为胼胝体压部、尾部、半卵圆中心病灶,1例头颅MRI正常,1例患儿治疗6 d复查胼胝体病变较前明显吸收,5例患儿治疗后2~3周复查头颅MRI均正常。脑电图检查基本节律慢化3例,伴随脑电图痫样放电2例,脑电图正常2例。治疗后有惊厥5例,惊厥持续状态1例,其中伴有发热、腹泻、咳嗽等感染表现的为4例,无感染性因素惊厥1例。结论本病经对症治疗后预后良好,MRI表现正常,MRI对疾病进行鉴别能正确判断预后。

Objective To analyze the clinical manifestations, MRI data and follow-up of children＇s reversible corpus callosum syndrome （RESLES）, and summarize their MRI features. Methods Six children with RESLES admitted in neurology department of our hospital were enrolled in the study. The clinical manifestations of children were recorded. The clinical ffect and follow-up results of RESLES children were analyzed by cranial MRI. Results Six cases of children with head MRI examination revealed 5 cases of RESLES-Ⅱtype, showed round lesions of the corpus callosum; 1 case of RESLES-Ⅱtype showed central corpus callosum, caudate and semiovalence, 1 case of skull MRI was normal, 1 case of childrent reated for 6 days to review the corpus callosum lesions was significantly absorbed than before, 5 cases of children treated for 2-3 weeks to review the skull MRI were normal. EEG basic rhythm moderation in 3 cases were found, accompanied by EEG epileptiform discharge in 2 cases, 2 cases of normal EEG. After treatment, there were 5 cases of convulsions and 1 case of continuous convulsion, including 4 cases of fever, diarrhea, cough and other infections, and 1 case of non-infectious convulsion. Conclusion After the symptomatic treatment of this disease, the prognosis is good, MRI performance is normal, MRI to identify the disease can correctly determine the prognosis.