Matsukawa Y, Mizutani T, Kitamura N, Takei M, Hayama T, Nishinarita S, Horie T, Sawada S, Tagusagawa A, Tsuchiya M, Takasu T
First Department of Internal Medicine, Nerima-Hikarigaoka Hospital, Japan.
Clin Rheumatol. 1996 Sep;15(5):501-3. doi: 10.1007/BF02229651.
We present the unusual case of 16-year-old girl who developed intractable convulsions five days after the onset of a cold. Meningeal signs, lymphopenia, proteinuria, and lupus anticoagulant were also present. Treatment with anticonvulsants, antituberculous agents, and adenine arabinoside were ineffective. The initiation of methylprednisolone pulse therapy immediately resolved convulsions and fever. The diagnosis, suggested by the clinical course and the marked improvement of the meningoencephalitis by pulse therapy, was an encephalitic form of acute disseminated encephalomyelitis. Clinical and laboratory findings indicated that an immune disorder may have triggered an abnormal response to a viral infection leading to this patient's neurologic disorder.
我们报告了一例不寻常的病例,一名16岁女孩在感冒发作五天后出现顽固性惊厥。同时还存在脑膜刺激征、淋巴细胞减少、蛋白尿和狼疮抗凝物。使用抗惊厥药、抗结核药和阿糖腺苷治疗均无效。甲基强的松龙脉冲疗法开始后,惊厥和发热立即得到缓解。根据临床病程以及脉冲疗法使脑膜脑炎明显改善,诊断为急性播散性脑脊髓炎的脑炎性形式。临床和实验室检查结果表明,免疫紊乱可能引发了对病毒感染的异常反应,导致该患者出现神经疾病。