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带状疱疹性脊髓炎7例临床特征分析
Clinical analysis of 7 cases of varicella-zoster virus myelitis
【摘要】 目的探讨带状疱疹性脊髓炎的临床特点、影像学特征、诊疗及预后。方法对7例带状疱疹性脊髓炎患者的临床资料进行回顾性分析,并进行临床随访。结果 7例患者均有特征性皮疹及脊髓损害症状。5例以皮疹首发,2例以脊髓损害症状首发。4例受累皮节与脊髓节段相符,3例受累皮节低于脊髓损害水平。7例脊髓MR均表现为受累脊髓节段性不规则长T1、长T2信号,2例有强化。胸髓病变5例,颈髓2例。7例患者均予激素治疗,5例患者同时予抗病毒治疗。经1236个月(平均22.7±8.1个月)随访,5例患者痊愈,1例遗留双手指轻微麻木,1例遗留排尿困难。结论带状疱疹性脊髓炎常表现特征性的皮疹和脊髓症状,积极的抗病毒药物和皮质激素治疗,预后较好。
【Abstract】 Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of varicella zoster virus myelitis. Methods The clinical data of 7 varicella zoster virus myelitis patients were retrospectively analyzed and clinical follow-up was conducted. Results Seven patients had characteristic skin rash and symptoms of spinal cord injury. The initial symptoms including rash in 5 cases and spinal cord damage symptoms in 2 cases. The affected skin sections were consistent with the spinal cord segment in 4 cases, and below the level of spinal cord injury in 3 cases. All 7 cases were confirmed by spinal MRI with segmental spinal cord lesions as evidenced by long T1 and long T2 signals in the affected spinal cord including enhancing lesion in 2 cases. Lesions located in thoracic cord in 5 cases and in cervical cord in two cases. All patients received steroid hormone treatment. Among them, 5 patients received additional antiviral treatment. After 1236 months follow-up, 5 cases were cured, 1 case left with sphincter dysfunction and 1 case with slight numbness of hands. Conclusion Varicella zoster virus myelitis is characterized by characteristic rash and spinal cord symptoms. Antiviral drugs and corticosteroid therapy can yield better prognosis.
【Key words】 Varicella-zoster virus; Myelitis; Disease characteristics; Treatment;
- 【文献出处】 中国神经精神疾病杂志 ,Chinese Journal of Nervous and Mental Diseases , 编辑部邮箱 ,2017年11期
- 【分类号】R744.3
- 【被引频次】6
- 【下载频次】253