摘要
目的探讨低血糖脑病的病因、临床和神经影像学特点。方法回顾性分析28例低血糖脑病患者的病因、临床和神经影像学资料。结果本组患者13例有明确糖尿病史,均行降糖药物治疗;8例患者疑糖尿病而服降糖药物,胰岛素瘤4例,原因不明3例。临床表现为意识障碍14例,言语不清、反应迟钝5例,偏瘫和单侧肢体瘫痪3例,精神行为异常3例,痫性发作3例。8例头颅CT或MRI未见明显异常;7例头颅CT示双侧基底节区对称性低密度灶,20例MRI检查异常,主要累及双侧基底节区、大脑皮质、皮质下白质、海马、胼胝体压部和脑干,表现为等或稍长T1、长T2异常信号,Flair像呈高信号,弥散加权成像(DWI)呈高信号。结论低血糖脑病的病因主要是过量使用降糖药物和胰岛素瘤,其临床表现复杂多样,动态监测血糖意义重大,MRI有高度特异性,DWI序列对病变更敏感。
Objective To investigate the etiological, clinical and neuroimaging features of hypoglycemic encephalopathy（HE）. Methods 28 hypoglyeemie encephalopathy patients were analyzed including the etiological, clinical and neuroimaging data retro- spectively. Results Among all the HE cases, there was 13 cases of diabetes mellitus, which were treated by hypoglycemie agents, 8 cases of possibly diabetes mellitus, which were administrated with oral hypoglycemic agents and 4 cases of insulinoma with un- clear reason. There were 14 cases of conscious disturbance; 5 cases of slurred speech and clumsy response, 3 cases of hemiplegia or monoplegia, 3 cases of psycho and behavior disorder and 3 cases of epileptic seizure. There was no abnormalities in CT scan or MR/in 8 cases, and 7cases with symmetrical hypodensity at the basal ganglia in CT scan, and 20 cases with abnormalities in MRI. The lesions were involved in bilateral basal ganglia, cerebral cortex, subeortical white matter , hippocampus, splenium of corpus eallosum and brain stem. There were isointense or hypointense abnormalities on T1W I and hyperintense abnormalities on T2W I and Flair and DW I in the lesions. Conclusion The chief causes of hypoglycemic encephalopathy is th useness of hypoglycemie a- gents and insulinima. Its clinical manifestation is very complicated . It is very important for continuous monitoring blood glucose. It is high degree of specificity for MRI. Especially, and DWI is more sensitive for lesions .
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第30期3056-3057,3060,共3页
Chongqing medicine
关键词
低血糖脑病
磁共振成像
病因
hypoglycemia
magnetic resonance imaging
etiological factor
