ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2019, Vol. 11 ›› Issue (5): 435-437.doi: 10.3969/j.issn.1674-3865.2019.05.018

• 临床研究 • 上一篇    下一篇

32例儿童可逆性胼胝体压部病变综合征临床特点及文献复习

南在元,王春雨,张哲,王琳琳,郝艳秋   

  1. 150010哈尔滨,哈尔滨市儿童医院神经内科(南在元,王春雨,张哲,王琳琳);150086 哈尔滨,哈尔滨医科大学附属第二医院儿科(郝艳秋)
  • 出版日期:2019-11-01 发布日期:2019-11-08
  • 通讯作者: 郝艳秋,E-mail:1801203478@qq.com
  • 作者简介:南在元(1982-),男,医学硕士,主治医师。研究方向:小儿神经系统疾病的诊治

Clinical Analysis of 32 children with reversible splenial lesion syndrome and literature review

NAN Zaiyuan,WANG Chunyu,ZHANG Zhe,WANG Linlin,HAO Yanqiu   

  1. Department of Neurology, Harbin Children's Hospital,Harbin 150010,China
  • Online:2019-11-01 Published:2019-11-08

摘要:
目的
探讨儿童可逆性胼胝体压部病变综合征的临床特征,提高对此类疾病的认识。
方法
收集2016年1月1日至2018年6月30日于哈尔滨市儿童医院住院的32例MRI检查提示有胼胝体压部病变的患儿的临床资料、实验室检查、影像学资料及随访情况。
结果
32例患者中男17例,女15例;幼儿22例,儿童及青春期10例;23例以消化道症状起病,5例以颅内感染起病,4例以单纯抽搐发作为首发症状;28例为病毒感染,4例为细菌感染;30例仅累及胼胝体压部,2例同时累及胼胝体膝部及丘脑;29例头颅MRI胼胝体压部病变于2周内消失,临床症状于1周内缓解;其中有2例先完善头颅CT未发现病灶。
结论
幼儿期的患者以消化道症状起病,伴随抽搐症状,病原体以病毒感染为主时应高度怀疑可逆性胼胝体压部病变综合征,即使头CT检查未发现病灶,也有必要完善颅脑MRI检查。

关键词: 胼胝体压部病变综合征, 可逆性, 儿童

Abstract: Objective
To explore the clinical features of children with reversible splenial lesion syndrome and to improve the understanding of the diseases.
Methods
A total of 32 children hospitalized in Harbin Children's Hospital from Jan. 1,2016 to June 30,2018 were included, whose MRI examination suggested that they had splenial lesion. Clinical data, laboratory examination, imaging data and follow-up data of them were analyzed retrospectively.
Results
Among the 32 children, 17 were male and 15 were female. There were 22 infants and 10 children and adolescents. Of these children, 23 cases started with gastrointestinal symptoms, 5 cases with intracranial infection, and 4 cases with simple convulsion as the first symptom. There were 28 cases of viral infection and 4 cases of bacterial infection. Only splenium of corpus callosum was involved in 30 cases, while in two cases both the splenium and genu of corpus callosum and thalamus were involved. The clinical symptoms of 29 cases were relieved within 1 week, and the splenial lesion disappeared within 2 weeks after the MRI review. No lesion was found in two cases with previous CT of head.
Conclusion
Patients with gastrointestinal symptoms in early childhood, accompanied by convulsion symptoms, and viral infection as the main pathogen should be highly suspected of reversible splenial lesion syndrome. Even there were no lesions been found in the CT, it is also necessary to use the MRI.

Key words: Corpus Callosum, Reversible, Children