摘要
目的探讨带状疱疹感染性脊髓炎(VZVM)的临床特点。方法分析9例VZVM患者的临床资料以及随访结果。结果9例患者发病年龄33~72岁,平均年龄(52.1±5.2)岁,均在典型带状疱疹皮疹后出现急性或亚急性不完全性脊髓炎的表现,皮疹与脊髓炎的间隔时间为14~48 d,平均(27.7±11.9)d。脊髓磁共振检查均见髓内长T2信号病灶,其中8例病灶长度小于3个脊髓节段,增强磁共振检查均见病灶强化。9例患者中1例血清水通道蛋白4抗体阳性;8例患者脑脊液检查其中4例细胞数轻度增高。8例给予激素治疗,其中3例联合阿昔洛韦或更昔洛韦抗病毒治疗,平均随访(31±20)个月,无1例复发,平均扩展功能障碍状态量表(EDSS)评分由疾病最高峰时2.8减少到0.7。结论VZVM病情较轻,预后较好。激素治疗有效,但应注意视神经脊髓炎谱系疾病的可能。
Objective To investigate the clinical features of patients with varicella zoster virus(VZV)infection-related myelitis(VZVM).Methods The clinical date of 9 patients with VZVM were retrospectively analyzed.Results The average age of onset was 52.1 years(range 33-72 years).All patients developed acute or subacute partial myelitis after the characteristic skin rash,with an average interval between rash and myelitis of 27.7 days(range 14-48 days).Spinal MRI revealed segmental spinal cord lesions with hyperintensity on T2-weighted images and lesions enhncement in all patients,with short spinal lesions(less than three contiguous vertebral segments)in eight patients.Aquaporin-4 antibody was positive in one patient,and white cell counts in cerebrospinal fluid were elevated in four of eight patients.Eight patients were treated with glucocorticosteroid and three patient also receiving antiviral therapy.Over the time of follow-up,no patients experienced relapses,and the Expanded Disability Status Scale(EDSS)score deceased from 2.8 in nadir to 0.7 on average.Conclusion The clinical symptoms and signs of patients with VZVM seems to not severe and have better prognosis.Glucocorticosteroid treatment may be effective.VZV infection may trigger neuromyelitis optica spectrom disorder.
作者
魏世栋
李晓晖
任士卿
Wei Shidong;Li Xiaohui;Ren Shiqing(Department of Neurology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)
出处
《脑与神经疾病杂志》
2020年第7期419-422,共4页
Journal of Brain and Nervous Diseases
关键词
带状疱疹感染性脊髓炎
临床表现
治疗
预后
Varicella zoster virus infection-related myelitis
Clinical features
Treatment
Prognosis
