Ohori N, Kinoshita T, Toda K, Ohta S, Yoshimura T
Department of Neurology, Shimonoseki Kosei Hospital.
Rinsho Shinkeigaku. 1999 Nov;39(11):1156-9.
A 54-year-old woman visited our emergency service complaining of a severe language disturbance. She was fluently speaking something but most of the words were merely meaningless syllables. This jargon state lasted only four hours, then her abnormal speech rapidly and completely recovered within 24 hours. She had also suffered from painful oral ulcers, fever and erythema-like eruptions on her face for about three weeks. Skin biopsy of a facial lesion revealed a dense infiltrate of neutrophils in the dermis and minimal features of vasculitis, which, with other typical clinical findings, led us to the diagnosis of Sweet's syndrome. Although head CT scans, MRIs, MRA or SPECT could not detect any brain lesions, a cerebrospinal fluid examination showed a mild pleocytosis of 38/mm3 with 47% polymorphonuclear cells. There have been a few case reports on Sweet's syndrome accompanying neurologic symptoms, most of which are mild meningitis. We speculate that the transient aphasia was due to a focal lesion in the central nervous system attributable to Sweet's syndrome. Sweet's syndrome might bring inflammatory or ischemic lesions to the cerebrum as Behçet's disease.
一名54岁女性因严重语言障碍前来我们的急诊室就诊。她能流利地说着一些话,但大多数词语只是无意义的音节。这种胡言乱语状态仅持续了4个小时,随后她的异常言语在24小时内迅速且完全恢复。她还患有疼痛性口腔溃疡、发热以及面部红斑样皮疹约三周时间。面部病变的皮肤活检显示真皮中有密集的中性粒细胞浸润以及轻微的血管炎特征,结合其他典型临床表现,我们诊断为Sweet综合征。尽管头部CT扫描、MRI、MRA或SPECT均未检测到任何脑部病变,但脑脊液检查显示轻度细胞增多,白细胞计数为38/mm³,其中47%为多形核细胞。已有一些关于Sweet综合征伴有神经症状的病例报告,其中大多数为轻度脑膜炎。我们推测短暂性失语是由于Sweet综合征导致的中枢神经系统局灶性病变所致。Sweet综合征可能像白塞病一样给大脑带来炎症性或缺血性病变。