Cassinotto C, Mejdoubi M, Signate A, Herbland A, Olindo S, Deramond H
Service de neurologie, CHU La Meynard, 97200 Fort-de-France, France.
J Neuroradiol. 2008 Oct;35(4):217-23. doi: 10.1016/j.neurad.2008.02.002. Epub 2008 Apr 23.
Star-fruit ingestion has been previously reported to cause severe neurotoxicity in uremic patients with symptoms ranging from hiccups, vomiting and consciousness disturbances to refractory status epilepticus, coma and death. MRI examinations of five uremic patients with severe neurological disturbances following star-fruit intoxication were reviewed. At the time of MRI, all patients presented with a confusional state, preceded by seizures in three cases. MRI showed focal (four patients) and diffuse (one patient) cortical hyperintensity on diffusion-weighted sequences, with a corresponding low apparent diffusion coefficient. An additional area of increased diffusion intensity was observed in the pulvinar (two patients) and hippocampus (two patients). MRI and diffusion-weighted imaging may be useful for the diagnosis of star-fruit neuro-intoxication which is associated with a poor prognosis and requires acute and appropriate treatment.
此前有报道称,食用杨桃会导致尿毒症患者出现严重神经毒性,症状包括打嗝、呕吐、意识障碍,直至难治性癫痫持续状态、昏迷和死亡。回顾了5例杨桃中毒后出现严重神经功能障碍的尿毒症患者的MRI检查结果。在进行MRI检查时,所有患者均处于意识模糊状态,其中3例患者之前有癫痫发作。MRI在扩散加权序列上显示局灶性(4例患者)和弥漫性(1例患者)皮质高信号,相应的表观扩散系数较低。在丘脑枕(2例患者)和海马体(2例患者)中观察到另外一个扩散强度增加的区域。MRI和扩散加权成像可能有助于诊断杨桃神经中毒,这种中毒预后较差,需要进行紧急且适当的治疗。