摘要
目的分析总结15例临床诊断伴颅内结构受累的Ramsay-Hunt综合征的临床资料特点及治疗效果,以提高对本病的认识和诊断水平。方法回顾性分析2007～2011年收治的经临床证实的15例伴颅内结构受累的Ramsay-Hunt综合征,记录总结其临床特点、实验室检查、治疗效果等临床资料。结果 15例患者中男性5例,女性10例,年龄18～80岁,冬春季多发。累及脑膜者10例,累及脑、脑干者5例,同时累及脑膜、脑、脑干者2例。15例患者临床多表现为偏侧面瘫、外耳道疱疹、听力减退、意识障碍、锥体束征等。脑膜受累者治疗有效率为90%,脑干受累者治疗有效率为80%。结论 Ramsay-Hunt综合征合并颅内结构受累患者临床表现多种多样,易漏诊。偏侧面瘫、外耳道疱疹、听力减退是最常见的临床表现,同时合并脑膜、脑及脑干受累症状。及早发现诊断,静脉使用阿昔洛韦积极治疗,效果较好。
Objective To improve the diagnosis of Ramsay-Hunt syndrome （RHS） by analyzing the clinical materials. Meth- ods The clinical characteristics of the 15 cases of RHS with involvement of intracranial structures in our hospital from 2007 to 20tl were retrospectively reviewed and analyzed,including clinical manifestation,laboratory examination and treatment. Results Of the 15 patients,there were 5 men and 10 women with age ranging from 18 to 80 years. Most of them occurred in winter and spring. Ten patients complicated with meningitis ;5 cases with brain and brainstem involvement;meninges, brain and brainstem in- volvement in 2 cases. The clinical manifestation of the 15 cases included unilateral peripheral facial palsy ,herpes zoster oticus, hearing loss, disturbed consciousness and pyramidal sign. The effective rate of treatment was 90% in patients with meningeal in- volvement,and was 80% in patients with brainstem involvement. Conclusion RHS with intracranial structure involvement has wide variety of clinical manifestations and is easy to be misdiagnosed. The most common manifestations are facial palsy, herpes zoster oticus and hearing loss. Involvement of any structure or system in the central nervous system（ meningeal ,brainstem） are al- so be necessary. The early diagnosis and intravenous acyclovir will achieve a better curative effect.
出处
《中华全科医学》
2013年第1期16-17,共2页
Chinese Journal of General Practice
