临床孤立综合征引发儿童视觉、听觉障碍1例报告

Clinically isolated syndrome causes visual and hearing impairment in children:a case report

目的了解临床孤立综合征(CIS)的临床特征。方法回顾分析1例CIS导致视力、听力损害患儿的临床资料。结果患儿,男,5岁7个月,以视力不佳就诊,体检无异常。右眼视力0.15,左眼0.15。视觉诱发电位示右眼P100波峰延迟,振幅降低;左眼P100波峰延迟,振幅降低。脑干听觉诱发电位,DPOAE右耳各频率均未通过,左耳4 KHz、8 KHz通过,其余各频率均未通过;TEOAE双耳均未通过。脑电图、智力测验(WPPSI)均无异常。头部和眼眶的MRI检查提示脱髓鞘病变。符合"一次局灶或多灶性临床中枢神经系统事件,推测与炎症性脱髓鞘有关"的CIS诊断标准。结论 CIS可引起视觉和听觉障碍。

Objective To explore the clinical characteristics of clinically isolated syndrome(CIS).Method The clinical data of visual and hearing impairment caused by CIS in a child were retrospectively analyzed.Results A boy aged 5 years and 7 months visited the clinic due to poor eyesight and no abnormality was found in physical examination.His visual acuity of the right eye was 0.15,and the left eye was 0.15.Visual evoked potential showed delayed P100 peak and decreased amplitude in both right and left eyes.Brainstem auditory evoked potential and Distortion Product Otoacoustic Emissions(DPOAE)testing indicated that all the frequencies did not pass in the right ear;the frequencies except 4 kHz and 8 kHz did not pass in the left ear.TEOAE showed no frequencies passed in two ears.Neither electroencephalogram nor intelligence test(WPPSI)was abnormal.MRI examination of head and orbit suggested demyelination.These findings are consistent with the CIS diagnostic criteria for"A focal or multifocal clinical central nervous system event presumably associated with inflammatory demyelination".Conclusion CIS can cause visual and hearing impairments.