Dang Jing, Chen Jihua, Bi Fangfang, Tian Fafa
The Department of Neurology, Xiangya Hospital, Central South University, Changsha.
The Department of Neurology, The First People's Hospital of Chenzhou, Chenzhou, China.
Medicine (Baltimore). 2019 Apr;98(17):e15273. doi: 10.1097/MD.0000000000015273.
To understand the clinical and pathological features of 1,2-dichloroethane (DCE) toxic encephalopathy.The cases of 4 patients who were admitted to Xiangya hospital between January 8, 2008 and November 8, 2012 with diagnoses of DCE toxic encephalopathy were examined. We recorded data on gender, age of onset, exposure time to DCE, symptom onset to admission interval, symptom onset to worst symptom experience interval, and clinical manifestations, as well as cranial magnetic resonance imaging (MRI) and brain biopsy pathology results.All 4 patients had a history of DCE exposure and presented with symptoms of intracranial hypertension. Cranial MRI revealed extensive brain edema throughout the subcortical white matter, the bilateral globus pallidus, and the cerebellar dentate nuclei. The brain biopsy confirmed severe cerebral edema, including peripherovascular edema, with swelling of various cell types, with extensive glial cell necrosis. After treatment with steroids and mannitol (3-10 weeks), all 4 patients recovered, partially or completely.Severe brain edema and extensive glial cell necrosis were the main pathological features observed in the present cases, with a likely etiology of DCE toxicity. Early, prompt, and long-term treatment with dehydrating agents and glucocorticoids was an effective treatment for this condition.
了解1,2 - 二氯乙烷（DCE）中毒性脑病的临床和病理特征。对2008年1月8日至2012年11月8日期间入住湘雅医院并诊断为DCE中毒性脑病的4例患者进行了检查。我们记录了患者的性别、发病年龄、DCE暴露时间、症状出现至入院间隔、症状出现至最严重症状经历间隔、临床表现，以及头颅磁共振成像（MRI）和脑活检病理结果。所有4例患者均有DCE暴露史，并出现颅内高压症状。头颅MRI显示整个皮质下白质、双侧苍白球和小脑齿状核广泛脑水肿。脑活检证实为严重脑水肿，包括血管周围水肿，各种细胞类型肿胀，伴有广泛的神经胶质细胞坏死。经类固醇和甘露醇治疗（3 - 10周）后，所有4例患者均部分或完全康复。严重脑水肿和广泛的神经胶质细胞坏死是本病例观察到的主要病理特征，可能病因是DCE毒性。早期、及时且长期使用脱水剂和糖皮质激素治疗是本病的有效治疗方法。
