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一名患有后部可逆性脑病综合征的患者出现双侧皮质盲,随后发生全身强直阵挛性癫痫发作的病例。

A case of bilateral cortical blindness followed by generalised tonic-clonic seizure epilepsy in a patient with posterior reversible encephalopathy syndrome.

作者信息

Zhao Benqi, Si Shancheng

机构信息

Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 102218, Beijing, China.

Eye Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 102218, Beijing, China.

出版信息

Heliyon. 2024 Sep 7;10(18):e37642. doi: 10.1016/j.heliyon.2024.e37642. eCollection 2024 Sep 30.

Abstract

Posterior reversible encephalopathy syndrome (PRES) in end-stage kidney disease (ESKD) is rare, with ocular symptoms as the first manifestation being even rarer. Here, we report a case of PRES in a patient with ESKD, characterized by sudden binocular blurred vision followed by epilepsy, to improve the understanding of this syndrome among nephrologists and ophthalmologists. A 50-year-old female requested an ophthalmic consultation due to bilateral vision loss followed by generalised tonic-clonic seizures. One month before onset of current illness, she developed ESKD secondary to rapid progression of previous ANCA vasculitis associated renal damage. Latter magnetic resonance imaging confirmed the diagnosis of PRES. Two weeks later, the patient's vision fully recovered. : PRES is not an etiological diagnosis but a neuroimaging sign. In addition, PRES is a danger signal that is usually reversible if recognized and treated early, and can be life-threatening if treatment is delayed.

摘要

终末期肾病(ESKD)中的后部可逆性脑病综合征(PRES)较为罕见,以眼部症状作为首发表现的情况更为罕见。在此,我们报告一例ESKD患者发生PRES的病例,其特征为突发双眼视力模糊,随后出现癫痫发作,以提高肾病学家和眼科医生对该综合征的认识。一名50岁女性因双侧视力丧失并继发全身性强直阵挛发作而寻求眼科会诊。在当前疾病发作前一个月,她因先前抗中性粒细胞胞浆抗体(ANCA)血管炎相关肾损伤的快速进展而发展为ESKD。后来的磁共振成像证实了PRES的诊断。两周后,患者视力完全恢复。:PRES不是病因诊断,而是一种神经影像学征象。此外,PRES是一个危险信号,如果早期识别并治疗通常是可逆的,如果治疗延迟则可能危及生命。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c49a/11416281/e9cc2c513ef5/gr1.jpg

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