以假性周围神经麻痹为首发症状的急性缺血性脑卒中临床分析

Analysis of patients with acute ischemic stroke presented as pseudoperipheral palsy

目的分析以假性周围神经麻痹为首发症状的急性缺血性脑卒中患者的临床特点及早期诊断。方法回顾性分析15例首发症状为假性周围神经麻痹的急性缺血性脑卒中患者的临床资料。结果15例患者中,男性多见,均为急性起病,首发症状为假性周围神经麻痹,部分患者病情进展,均由头颅MRI确诊为急性脑梗死,>50%的患者存在颅内动脉狭窄或闭塞,脑血管病高危因素多为高同型半胱氨酸血症和高血压,治疗上主要采取抗栓、降脂,预后良好。结论临床上以假性周围神经麻痹为首发症状的急性缺血性脑卒中患者较为罕见,极易误诊,对急性起病的有脑血管病高危因素的男性周围神经麻痹患者,仍需尽早行头颅MRI检查以明确诊断。

Objective To analyze the clinical characteristics and early diagnosis of patients with acute ischemic stroke(ACS)presented as pseudoperipheral palsy.Methods The clinical data of 15 patients with ACS presented as pseudoperipheral palsy were retrospectively analyzed.Results Fifteen ACS patients,mostly male,all with acute onsets,presented as pseudoperipheral palsy.Some patients became severe,and finally the diagnoses were confirmed by brain MRI in all the patients.More than half of the patients had intracranial arterial stenosis or occlusion,and hyperhomocysteinemia and hypertension were the main risk factors.Antithrombosis and statin were the main treatment.All the patients had good prognosis.Conclusion ACS patients presented as pseudoperipheral palsy are rare and may easily be misdiagnosed.Therefore,for male patients with vascular risk factors presented as peripheral palsy may need brain MRI for early diagnosis.