Sagisaka Shogo, Tamune Hidetaka, Shimizu Keiki, Kashiyama Tetsuya
Department of Emergency Medicine Tokyo Metropolitan Tama Medical Center Fuchu Tokyo Japan.
Department of Emergency and Critical Care Medicine Japanese Red Cross Medical Center Shibuya-ku Tokyo Japan.
J Gen Fam Med. 2018 May 31;19(4):136-138. doi: 10.1002/jgf2.178. eCollection 2018 Jul.
We report a rare case of full neurological recovery in a 77-year-old woman with an initial Glasgow Coma Scale of 3 while taking a bedrock bath. Severe heatstroke was quickly diagnosed, and intensive treatment was immediately provided. Laboratory data showed multi-organ failure, and her electroencephalogram showed very low amplitude, indicating a poor prognosis; however, she gradually recovered consciousness, and her electroencephalogram normalized, showing a Glasgow Coma Scale of 15 at discharge. This case demonstrated that physicians should pay careful attention when withholding treatment from a patient with severe heatstroke accompanied by a poor initial electroencephalogram result and laboratory data.
我们报告了一例罕见病例，一名77岁女性在进行石浴时初始格拉斯哥昏迷量表评分为3分，最终实现了完全神经功能恢复。严重中暑很快被诊断出来，并立即给予了强化治疗。实验室检查显示多器官功能衰竭，脑电图显示波幅极低，提示预后不良；然而，她逐渐恢复意识，脑电图恢复正常，出院时格拉斯哥昏迷量表评分为15分。该病例表明，对于初始脑电图结果和实验室检查数据不佳的严重中暑患者，医生在停止治疗时应谨慎行事。
