摘要
目的探讨恶性肿瘤并发Wernicke脑病患者的早期诊断。方法回顾性分析4例恶性肿瘤并发Wernicke脑病患者的临床、影像学资料。结果 4例患者中源于白血病2例,胃癌1例,小肠间质瘤1例,病前均有硫胺素摄入不足病史。临床均表现为不同程度的精神、意识障碍及运动功能障碍(包括四肢无力,站立、行走困难),头颅MR平扫显示T1WI低信号、T2WI高信号、FLAIR高信号的异常信号影,多对称分布在中线结构如中脑导水管、第三脑室、第四脑室的周围及乳头体。3例患者经补充大剂量硫胺素后症状迅速好转,1例放弃治疗。结论详细的病史、典型的临床表现以及头颅MR检查能为恶性肿瘤并发Wernicke脑病患者的早期诊断提供帮助,及早补充大剂量硫胺素是治疗的关键。
Objective To investigate the early diagnosis of maglinant tumor complicated by Wernicke encephalopathy patients.Methods The clinical and imaging characteristics of 4 cases of Wernicke encephalopathy were analyzed retrospec -tively.Results Among 4 patients,there were 2 cases of leukemia,1 case of gastric cancer,1 case of intestinal stormal tumor, All patients had inadequate intake of thiamine before onset .The clinical characteristics of Wernicke encephalopathy were dif -ferent dagree psychiatric and mental disorder ,motor function disorder （including extremities weakness ,standing and walking difficulty）.In cranial MR, all cases were found low signals on T1 weighted images （T1WI） and high signals on T2WI and FLAIR in the third and fourth cerebral ventricles , aqueduct of midbrain, and bulla of fornix.3 cases with thiamine supple-mentation were significantly improved .1 case gave up treatment.Conclusion Detail history taking, the typical clinical mani-festations and cranial MR findings are important for early diagnosis of malignant brain disease complicated by Wernicke , early high-dose thiamine supplements is the key to treatment .
出处
《疑难病杂志》
CAS
2014年第3期242-244,F0003,共4页
Chinese Journal of Difficult and Complicated Cases
基金
国家自然科学基金资助项目(No.81100897)
军事医学科学院附属医院创新基金(No.2012ycx18)
