Neurology, Royal United Hospital Bath NHS Trust, Bath, Bath and North East Somer, UK
Bristol Medical School (PHS), University of Bristol, Bristol, UK.
BMJ Case Rep. 2020 Nov 23;13(11):e237346. doi: 10.1136/bcr-2020-237346.
A 36-year-old man presented with an acute progressive encephalopathy, followed by tetraparesis and was diagnosed with acute disseminated encephalomyelitis (ADEM) complicating infection with measles virus. Despite demonstrating a typical rash and other early symptoms of measles infection, there was uncertainty around the initial diagnosis. Cerebrospinal fluid analysis and MRI of the brain and spinal cord were consistent with severe ADEM. He required treatment on intensive care but responded favourably to immunosuppressive therapy.This case highlights the importance of recognising acute measles infection, familiarity with the neurological complications and the potential for good outcome. Healthcare professionals must continue to play an active role in educating the public on the importance of maintaining herd immunity through universal immunisation.
一位 36 岁男性以急性进行性脑病起病,随后出现四肢瘫痪,被诊断为麻疹病毒感染并发急性播散性脑脊髓炎(ADEM)。尽管出现了典型皮疹和麻疹感染的其他早期症状,但最初的诊断仍不确定。脑脊液分析以及脑和脊髓 MRI 检查结果均符合严重 ADEM。他需要在重症监护病房接受治疗,但对免疫抑制治疗反应良好。本病例强调了认识急性麻疹感染、熟悉其神经并发症以及良好预后的重要性。医疗保健专业人员必须继续发挥积极作用,通过普遍免疫接种,向公众宣传保持群体免疫的重要性。