Yanagawa Youichi, Kiyozumi Tetsuro, Okada Yoshiaki, Ogawa Go, Kaida Kenichi, Kamakura Keiko
Department of Traumatology and Critical Care Medicine, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa-city, Saitama 359-8513, Japan.
No To Shinkei. 2006 Jun;58(6):509-13.
A seventy-four-male with disorientation and convulsion was transferred to this hospital after three days fever which was unknown origin. Because the examination of cerebrospinal fluid were; cell count 1,560/3 (N : L = 4 : 1), protein 305 mg/dl, sugar 91 mg/dl, he was treated as encephalitis. However, MRI of the 18th hospital day revealed bilateral thalamic lesion and disseminated white matter lesions, suggesting acute disseminated encephalomyelitis. He left dementia after treatment and transferred to another hospital. Since, it is difficult to make a differential diagnosis between encephalitis and acute disseminated encephalomyelitis, early establishment of diagnostic criteria for acute disseminated encephalomyelitis is required.
一名74岁男性,在不明原因发热三天后出现定向障碍和惊厥,被转至本院。因为脑脊液检查结果为:细胞计数1560/3(中性粒细胞:淋巴细胞=4:1),蛋白305mg/dl,糖91mg/dl,所以按脑炎进行治疗。然而,在住院第18天的磁共振成像显示双侧丘脑病变和散在性白质病变,提示为急性播散性脑脊髓炎。治疗后他遗留痴呆症状并转至另一家医院。由于脑炎和急性播散性脑脊髓炎之间难以进行鉴别诊断,因此需要尽早确立急性播散性脑脊髓炎的诊断标准。