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桥脑中央髓鞘溶解属罕见病.现将我院经MRI诊断并用光量子血疗的1例报告如下:患者女,39岁,突然失语、四肢瘫痪6小时入院.既往健康.夜间下床时晕倒、四肢不能活动、尿失禁.查体:神清颈软,内科检查无异常.神经系统:不能伸舌及吞咽,能以睁闭眼表示可否,眼球外展受限,双鼻唇沟变浅,双上肢肌力0,双下肢1级,腱反射亢进,病理反射阳性.脑CT正常.血尿常规、血糖、血氨正常.心电图正常.脑脊液蛋白50mg%,其余正常.诊断闭锁综合征性质待定.用抗菌素等综合治疗,同时用光量子血疗隔日一次.病情稳定.病后2周MRI检查见桥脑中上部上央区3.3×2.0×1.2cm类园形长T_1T_2异常信号,桥脑外形无肿大,四脑室及邻近脑池无改变,中脑未累及,其余脑质无异常.注射造影剂后病灶中央区呈斑块状均匀强化,周边无强化.符合桥脑中央髓鞘溶解.继续同前治疗,病情渐改善.四个月后双眼球活动良好,舌能伸出口腔,能吞咽.双上肢肌力Ⅲ双下肢Ⅱ级.
Central pontine myelinolysis is a rare disease. Now our hospital by MRI diagnosis and use of light quantum blood treatment in 1 case reported as follows: Female, 39 years old, suddenly aphasia, limb paralysis 6 hours admitted to hospital. Down, limbs can not move, urinary incontinence. Physical examination: Shen Qing neck soft, no abnormalities in the internal examination. Nervous system: can not stretch the tongue and swallowing, can open or closed eyes expresses the possibility of limited eye outreach, Shallow, upper extremity muscular strength 0, double lower extremity 1, tendon hyperreflexia, positive pathological reflex. Normal brain CT .Hematuria, blood glucose, blood ammonia normal. Electrocardiogram normal. Cerebrospinal fluid protein 50mg%, the rest of normal. Diagnosis of ataxia syndrome To be determined. With antibiotics and other comprehensive treatment, while the use of quantum phototherapy once every other day. Stable condition .2 weeks after the disease to see the pylons in the upper middle of the upper pyloric 3.3 × 2.0 × 1.2cm type garden-like T_1T_2 abnormal signal, No enlargement, no changes in the fourth ventricle and adjacent cisterns, no involvement of the midbrain, and no abnormalities in other brain regions. The focal area of the lesion in the central area of the lesion was uniformly stained with no enhancement around the center of the medulla oblongata after injection of contrast agent. Continue with the former treatment, the disease gradually improved. Four months after the binocular activities Good, the tongue can stretch out the mouth, can swallow. Upper limb muscle strength Ⅲ lower limb Ⅱ grade.