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[儿童播散性脑脊髓炎及其与多发性硬化的鉴别诊断]

[Disseminated encephalomyelitis in children and its differential diagnosis from multiple sclerosis].

作者信息

Efimenko V N

出版信息

Lik Sprava. 1998 Jul-Aug(5):122-6.

PMID:9793329
Abstract

Acute disseminated encephalomyelitis (ADEM) has been studied in a series of 30 children (16 girls, 14 boys) who ranged from 1.5 to 15 years old versus 24 pediatric patients (12 girls, 9 boys) aged 4-15 years with diagnosed disseminated sclerosis (DS). Conducted in the above series were the following investigations: computerized tomography, magnetic resonance imaging, recording of visual evoked potentials, indices for cellular and humoral immunity. ADEM, as distinct from DS, was marked by: an acute onset; the presence of general infectious symptoms together with general cerebral ones; involvement into the process of not only white matter but also of nuclear formations and peripheral nervous system; unidirectional course resulting in residual events. In 16 children a clear distinction was seen between ADEM and DS, while the rest of this pediatric population (n = 14) who had residual events presenting as pyramidal syndrome, might well develop DS in later life. Additional differential-diagnostic tests employed in the above study were found to be of little informative value.

摘要

对30名年龄在1.5至15岁的儿童(16名女孩,14名男孩)进行了急性播散性脑脊髓炎(ADEM)的研究,并与24名年龄在4至15岁、已确诊为播散性硬化症(DS)的儿科患者(12名女孩,9名男孩)进行对比。对上述两组患者进行了以下检查:计算机断层扫描、磁共振成像、视觉诱发电位记录、细胞免疫和体液免疫指标检测。与DS不同,ADEM的特点为:起病急;伴有全身感染症状和全脑症状;不仅白质受累,核团及周围神经系统也受累;病程单向性,可遗留后遗症。16名儿童的ADEM与DS有明显区别,而该儿科人群中的其他儿童(n = 14)遗留有锥体综合征等后遗症,很可能在以后的生活中发展为DS。上述研究中采用的其他鉴别诊断检查被发现信息价值不大。

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