Department of Neurology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, China.
J Neurol Sci. 2010 May 15;292(1-2):111-3. doi: 10.1016/j.jns.2010.01.022. Epub 2010 Feb 18.
This study describes the clinical and neuroimaging features of five patients with 1, 2-Dichloroethane (DCE) toxic encephalopathy. From January 1st 1998 to June 30th 2009, five patients who were subsequently diagnosed with DCE toxic encephalopathy were admitted to our hospital. All were female workers who had been in contact with DCE and subsequently had had seizures or symptoms of intracranial hypertension, including headache, nausea, and vomiting. The cranial MRI showed extensive brain edema in either the subcortical white matter, bilateral globus pallidus, and cerebellar nucleus dendatus, or the cortices. Of the five patients in the study, three had vasogenic edema, one had cytotoxic edema, and one had both types of edema. Following treatment with steroids and mannitol for 3 to 10 weeks, all patients made either a partial or complete recovery. The imaging findings were resolved on a follow-up MRI. It is clear that occupational exposure to DCE can cause severe toxic encephalopathy. Moreover, extensive brain edema, secondary to blood-brain barrier damage or neuronal injury, is the major neuroimaging feature and the cause of clinical manifestations. Early diagnosis and prompt treatment leads to a good outcome.
本研究描述了五例 1,2-二氯乙烷（DCE）中毒性脑病患者的临床和神经影像学特征。自 1998 年 1 月 1 日至 2009 年 6 月 30 日，我院收治了 5 例随后诊断为 DCE 中毒性脑病的患者。均为接触 DCE 的女性工人，随后出现癫痫发作或颅内高压症状，包括头痛、恶心和呕吐。头颅 MRI 显示广泛的脑水肿，位于皮质下白质、双侧苍白球和小脑齿状核，或皮质。研究中的 5 名患者中，3 名患者为血管源性水肿，1 名患者为细胞毒性水肿，1 名患者两种类型的水肿均有。在接受皮质类固醇和甘露醇治疗 3 至 10 周后，所有患者均部分或完全恢复。在后续的 MRI 上发现影像学表现得到缓解。很明显，职业性接触 DCE 可导致严重的中毒性脑病。此外，广泛的脑水肿是血脑屏障损伤或神经元损伤的结果，是主要的神经影像学特征和临床表现的原因。早期诊断和及时治疗可获得良好的预后。
