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急性播散性脑脊髓炎,一种罕见的疟疾后神经系统并发症:病例报告及文献复习。

Acute disseminated encephalomyelitis, a rare post-malaria neurological complication: Case report and review of the literature.

机构信息

Department of Internal Medicine, Centro Hospitalar de Setúbal, Setúbal, Portugal.

Department of Infectious Diseases, Centro Hospitalar de Setúbal, Setúbal, Portugal.

出版信息

Travel Med Infect Dis. 2019 Mar-Apr;28:81-85. doi: 10.1016/j.tmaid.2018.03.005. Epub 2018 Mar 21.

Abstract

There are four neurological complications that can occur after malaria treatment at a time when the patient is aparasitaemic: delayed cerebellar ataxia, acute inflammatory demyelinating polyneuropathy, post-malaria neurological syndrome and acute disseminated encephalomyelitis (ADEM). The authors describe a case of a 54-year-old male who presented with encephalopathy and generalized seizures forty-three days after complete recovery from acute malaria by Plasmodium falciparum. Diagnosis of post-malaria ADEM was made based on the acute onset of the neurological symptoms, characteristic findings in magnetic resonance imaging of the brain and prompt response to steroid therapy. ADEM is an autoimmune demyelinating disease of the central nervous system that usually arises after an infection or vaccination. Its occurrence after malaria infection is relatively rare, and to the best of our knowledge there are only thirteen cases described in the literature.

摘要

有四种神经并发症可能在疟疾患者寄生虫血症消除后发生

迟发性小脑共济失调、急性炎症性脱髓鞘性多发性神经病、疟疾后神经综合征和急性播散性脑脊髓炎(ADEM)。作者描述了一例 54 岁男性病例,该患者在完全从恶性疟原虫引起的急性疟疾中康复 43 天后出现脑病和全身癫痫发作。根据神经系统症状的急性发作、脑部磁共振成像的特征性发现以及对类固醇治疗的快速反应,诊断为疟疾后 ADEM。ADEM 是一种中枢神经系统自身免疫性脱髓鞘疾病,通常在感染或接种疫苗后发生。它在疟疾感染后的发生相对较少,据我们所知,文献中仅描述了 13 例。

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