阵发性交感神经过度兴奋五例诊治分析并文献复习

发布时间：2018-03-05 03:24

本文选题：交感神经系统　切入点：肌张力过强　出处：《中国全科医学》2014年05期 　论文类型：期刊论文

【摘要】：目的探讨阵发性交感神经过度兴奋(PSH)的临床表现及诊治方法,提高对PSH的认识。方法回顾性分析2009年2月—2013年5月我院神经内、外科病房及外院高压氧中心诊治的5例PSH患者的临床表现、实验室检查及治疗等资料。结果 5例患者中男4例、女1例,年龄25~77岁,其中严重脑创伤2例、反复脑梗死1例、缺血缺氧性脑病1例、脑出血1例。5例患者主要以阵发性躁动、高热、瞳孔散大、心动过速、血压升高、多汗、呼吸急促、肌张力障碍或姿势异常为临床表现。首次发作距原发病时间为1~60 d,发作时间为数分钟至半小时,发作频率1~10次/d,未发现昼夜规律,吸痰和排便为其可能的诱因。影像学检查提示颅脑损伤部位分散于额叶、顶叶、枕叶、颞叶、丘脑、小脑及脑干。抗癫痫治疗疗效不佳。结论 PSH病因不一,临床表现多样,早期容易误诊,目前主要是对症治疗。
[Abstract]:Objective to investigate the clinical manifestations, diagnosis and treatment of paroxysmal sympathetic hyperstimulation (PSH), and to improve the understanding of PSH. Methods from February 2009 to May 2013, the nerve in our hospital was analyzed retrospectively. Results the clinical manifestations, laboratory examination and treatment of 5 patients with PSH in surgical ward and hyperbaric oxygen center were analyzed. Results there were 4 males and 1 female, aged 2577 years, including 2 patients with severe brain trauma and 1 with recurrent cerebral infarction. In 1 case of ischemic hypoxic encephalopathy and 1 case of cerebral hemorrhage, paroxysmal restlessness, hyperpyrexia, dilated pupil, tachycardia, elevated blood pressure, hyperhidrosis and shortness of breath were the main causes. Dystonia or abnormal posture were clinical manifestations. The first attack was 60 days from the original onset, the attack time was several minutes to half an hour, the attack frequency was 110 / 10 / d, and no circadian regularity was found. Sputum aspiration and defecation were the possible inducements. Imaging examination showed that the site of craniocerebral injury was scattered in frontal lobe, parietal lobe, occipital lobe, temporal lobe, thalamus, cerebellum and brain stem. Early misdiagnosis is easy, the main treatment is symptomatic.
【作者单位】：浙江省湖州市中心医院神经内科;中国人民解放军第九八医院神经内科;
【分类号】：R338

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