5例带状疱疹性脊髓炎临床和影像学特征分析

发布时间：2018-11-06 13:27

【摘要】：目的分析带状疱疹性脊髓炎的临床和影像学特征。方法回顾性分析5例带状疱疹性脊髓炎患者临床和影像学资料。结果 5例患者均大于40岁,均出现典型带状疱疹皮疹,且皮疹与受累脊髓节段相对应,其中4例(4/5)患者以皮疹为首发表现,1例(1/5)患者先出现脊髓受累表现。脊髓受累主要表现肢体运动障碍5例(5/5)、感觉障碍4例(4/5)、括约肌功能障碍3例(3/5)。5例行脊髓MRI检查,全部可见髓内异常信号。3例患者行脑脊液水痘-带状疱疹病毒DNA检查,2例阳性。5例患者经阿昔洛韦联合糖皮质激素治疗后,有不同程度好转,未遗留明显后遗症。结论带状疱疹性脊髓炎好发于中老年患者,肢体运动障碍、感觉障碍、括约肌功能障碍是其主要临床表现,MRI检查有助于诊断,早发现、及时有效地治疗有利于预后且预后良好。
[Abstract]:Objective to analyze the clinical and imaging features of herpes zoster myelitis. Methods the clinical and imaging data of 5 patients with herpes zoster myelitis were retrospectively analyzed. Results all of the 5 patients were over 40 years old, all had typical herpes zoster rash, and the rash corresponded to the involved spinal cord segment. Four patients (4 / 5) had the first appearance of rash, and one patient (1 / 5) had spinal cord involvement first. Spinal cord involvement was mainly characterized by limb motor disorder (5 / 5), sensory dysfunction (4 / 5), sphincter dysfunction (3 / 5), spinal cord MRI examination (5 / 5). Abnormal intramedullary signals were observed in all patients. Three patients were examined with varicella-zoster virus DNA in cerebrospinal fluid, and 2 were positive. 5 cases were treated with acyclovir combined with glucocorticoid, and there were no obvious sequelae left behind after treatment with acyclovir and glucocorticoid. Conclusion Herpes zoster myelitis is a major clinical manifestation in middle and old patients with motor disorder, sensory disorder and sphincter dysfunction. MRI examination is helpful for diagnosis and early detection of herpes zoster myelitis. Timely and effective treatment is beneficial to prognosis and good prognosis.
【作者单位】：安徽医科大学附属安徽省立医院皮肤科;安徽医科大学附属安徽省立医院神经内科;
【分类号】：R752.12

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