Senbil Nesrin, Aydin O Faruk, Orer Hülya, Gürer Y K Yavuz
Department of Pediatric Neurology, Dr. Sami Ulus Children's Hospital, Ankara, Turkey.
Pediatr Neurol. 2004 Sep;31(3):214-7. doi: 10.1016/j.pediatrneurol.2004.03.011.
A 4-year-old male presented with only acute vision loss. His neurologic examination, funduscopic examination, and pupils were normal. Cranial magnetic resonance imaging revealed abnormal hyperintense, bilaterally symmetric lesions (on T(2)-weighted and fluid-attenuated inversion recovery, images) in bilateral optic radiations, pulvinar region in the thalami, crus posterior of internal capsules, periventricular white matter, and unilaterally left anterior pons. Elevated measles antibody titers in the cerebrospinal fluid confirmed the diagnosis of subacute sclerosing panencephalitis. Vision loss improved and cranial magnetic resonance imaging findings regressed,but myoclonic jerks and deterioration began 7 months later. The diagnosis of subacute sclerosing panencephalitis should be considered in cases with acute vision loss resulting from cortical blindness even when classical findings of the central nervous system do not exist.
一名4岁男性仅表现为急性视力丧失。其神经系统检查、眼底检查及瞳孔均正常。头颅磁共振成像显示双侧视辐射、丘脑枕叶区域、内囊后肢、脑室周围白质及左侧脑桥前部单侧出现异常高信号、双侧对称病变(在T2加权和液体衰减反转恢复图像上)。脑脊液中麻疹抗体滴度升高确诊为亚急性硬化性全脑炎。视力丧失有所改善,头颅磁共振成像结果也有所消退,但7个月后出现肌阵挛性抽搐并病情恶化。即使不存在中枢神经系统的典型表现,对于因皮质盲导致急性视力丧失的病例,也应考虑亚急性硬化性全脑炎的诊断。