Dixit S N, Bushara K O, Brooks B R
Neurology Department, University of Wisconsin Medical School-Madison, USA.
Wis Med J. 1997 May;96(5):39-41.
We studied the admission rate, risk factors, neurological complications and sequelae of heat stroke (HS) during the 1995 heat wave in Madison, Wisconsin. HS was epidemic in 1995 (2.3 cases/1000 admissions), compared to the ten-fold lower endemic rate in 1994 (0.2/ 1000). There were 11 cases of HS, 9 males and 2 females. Contributing factors were athletic events (2), working outdoors (3) and indoor activity with malfunctioning air-conditioning (6). Medical conditions contributing to poor temperature regulation included schizophrenia with neuroleptic treatment (2), amyotrophic lateral sclerosis receiving nortriptiline (1), multiple sclerosis (1), attention deficit disorder (1), cystic fibrosis (1) and alcoholism (1). Acute neurological complications occurred in all patients on presentation including coma (8/11.73%), stupor (2/ 11.18%) and seizures (1/11.9%). Two patients (1856) had persistent neurological sequelae in the form of a pan-cerebellar syndrome while the remaining 9 recovered fully. Importantly, avoidable factors contributed to all of the patients with underlying diseases. These patients are particularly at risk and should take adequate precautions during summer months.
我们研究了1995年威斯康星州麦迪逊市热浪期间中暑（HS）的入院率、危险因素、神经并发症及后遗症。1995年中暑呈流行态势（2.3例/1000例入院患者），相比之下，1994年的地方病发病率低10倍（0.2/1000）。共有11例中暑患者，9例男性，2例女性。促成因素包括体育赛事（2例）、户外工作（3例）以及空调故障时的室内活动（6例）。导致体温调节不良的医疗状况包括接受抗精神病药物治疗的精神分裂症（2例）、接受去甲替林治疗的肌萎缩侧索硬化症（1例）、多发性硬化症（1例）、注意力缺陷障碍（1例）、囊性纤维化（1例）和酗酒（1例）。所有患者就诊时均出现急性神经并发症，包括昏迷（8/11，73%）、木僵（2/11，18%）和癫痫发作（1/11，9%）。2例患者（1856）出现以全小脑综合征形式存在的持续性神经后遗症，其余9例完全康复。重要的是，所有患有基础疾病的患者均存在可避免因素。这些患者尤其危险，在夏季应采取充分的预防措施。
