Siemes H, Siegert M
Klin Padiatr. 1984 Nov-Dec;196(6):347-54. doi: 10.1055/s-2008-1034094.
Ten to 28 days after hospital admission cell count and/or total protein concentration showed no decrease or further increase in 33 children (25 boys, 8 girls) between 2 to 15-years of age who suffered from acute aseptic meningitis (causative agents: mumps virus in 9 children, enterovirus in 5 children). Three of these children had cerebral palsy as a possible predisposing factor. The onset of prolonged aseptic meningitis was protracted in some children. At hospital admission the clinical features of this disorder differed not from those in uncomplicated acute aseptic meningitis. In 4 children a one-sided and in 4 patients a doublesided peripheral facial paralysis occurred as a transitory complication. One child showed transient arterial hypertension. EEG was normal in most of the children or revealed a slight general slowing only. Apart from a slight enlargement of the ventricles in 3 children cerebral CT showed no abnormality. Complaints like vertigo, headache, and vomiting persisted for weeks or months in part of the children. During the course of the disease CSF reflected two different reactions: 1. further increase of total protein in combination with a minimal cellular response, affecting 2-10 years old boys and girls equally; protein electrophoresis revealing the pattern of severe blood-CSF barrier disturbance, 2. persistant elevation or further increase of both cell count and total protein occurring nearly exclusively in 6-15 years old boys, associated with the CSF-protein pattern of severe blood-CSF barrier disturbance and of oligoclonal gamma-fractions.(ABSTRACT TRUNCATED AT 250 WORDS)
在入院10至28天后,33名2至15岁患急性无菌性脑膜炎(病原体:9名儿童为腮腺炎病毒,5名儿童为肠道病毒)的儿童(25名男孩,8名女孩)的细胞计数和/或总蛋白浓度未出现下降或进一步升高。其中3名儿童有脑瘫这一可能的易感因素。部分儿童的无菌性脑膜炎病程迁延。入院时,这种疾病的临床特征与单纯急性无菌性脑膜炎并无不同。4名儿童出现单侧周围性面瘫,4名患者出现双侧周围性面瘫,均为短暂性并发症。1名儿童出现短暂性动脉高血压。大多数儿童脑电图正常,或仅显示轻度普遍减慢。除3名儿童脑室轻度扩大外,脑部CT未显示异常。部分儿童眩晕、头痛和呕吐等症状持续数周或数月。在疾病过程中,脑脊液呈现两种不同反应:1. 总蛋白进一步升高并伴有最小细胞反应,在2至10岁男孩和女孩中出现的几率相同;蛋白电泳显示严重血脑屏障紊乱模式;2. 细胞计数和总蛋白持续升高或进一步升高,几乎仅在6至15岁男孩中出现,伴有严重血脑屏障紊乱和寡克隆γ-组分的脑脊液蛋白模式。(摘要截短于250字)