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一名烧伤儿童的后部可逆性脑病综合征:病例报告及文献综述

Posterior reversible encephalopathy syndrome in a child after burns: A case report and literature review.

作者信息

He Xiaoying, Shi Dandan, Long Chenyan, Yang Jia, Tian Ju

机构信息

Department of Plastic Surgery, Zhongshan City People's Hospital, Zhongshan, China.

Department of Plastic Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.

出版信息

SAGE Open Med Case Rep. 2023 Mar 15;11:2050313X231157988. doi: 10.1177/2050313X231157988. eCollection 2023.

Abstract

Posterior reversible encephalopathy syndrome is a clinical-neuroradiological syndrome with typical neuroimaging features of posterior cerebral white matter changes that are usually reversible. However, there are only few reports of burns with posterior reversible encephalopathy syndrome in the literature. Hence, it is a clinical entity that many burn medicine physicians may be unfamiliar with. We report a case of severe burns complicated by posterior reversible encephalopathy syndrome in a 14-month-old male patient. On the eighth day of hospitalization, the child had persistent fever, occasional convulsions, eyes staring to the right, and high-pitched cry. Magnetic resonance imaging on day 10 showed the diagnosis is posterior reversible encephalopathy syndrome. We used hormone therapy to reduce cerebral oedema, oxcarbazepine to control convulsions, and multiple other drugs and physical measures to treat fever. The symptoms, signs, and imaging abnormalities of his posterior reversible encephalopathy syndrome were rapidly reversed in a short period of time. At the 1-year follow-up, the patient had recovered completely with no residual neurological signs and symptoms. To our knowledge, the patient may be the youngest recorded patient with both burns and posterior reversible encephalopathy syndrome. Careful observation, computed tomography, and magnetic resonance imaging can achieve early detection, early diagnosis, and early treatment of posterior reversible encephalopathy syndrome, which facilitates the achievement of desired therapeutic results. Further investigation is required to determine whether burns can serve as an independent posterior reversible encephalopathy syndrome causative factor and clarify the underlying pathogenesis mechanism.

摘要

后部可逆性脑病综合征是一种临床-神经影像学综合征,具有典型的大脑后部白质改变的神经影像学特征,通常是可逆的。然而,文献中仅有少数关于烧伤合并后部可逆性脑病综合征的报道。因此,这是一个许多烧伤科医生可能不熟悉的临床实体。我们报告一例14个月大男性患者严重烧伤并发后部可逆性脑病综合征的病例。住院第8天,患儿持续发热、偶有惊厥、双眼向右凝视及尖声哭叫。第10天的磁共振成像显示诊断为后部可逆性脑病综合征。我们使用激素治疗减轻脑水肿,奥卡西平控制惊厥,并使用多种其他药物和物理措施治疗发热。其后部可逆性脑病综合征的症状、体征及影像学异常在短时间内迅速逆转。在1年的随访中,患者已完全康复,无残留神经症状和体征。据我们所知,该患者可能是有烧伤和后部可逆性脑病综合征记录的最年幼患者。仔细观察、计算机断层扫描和磁共振成像可实现后部可逆性脑病综合征的早期发现、早期诊断和早期治疗,这有助于取得理想的治疗效果。需要进一步研究以确定烧伤是否可作为后部可逆性脑病综合征的独立致病因素,并阐明潜在的发病机制。

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