肌萎缩侧索硬化三例误诊分析

摘要

Objective To master the diagnostic code of amyotrophic lateral sclerosis( ALS ) for early diagnosis, avoid misdiagnosis . Methods The clinical of 3 cases of ALS that were early misdiagnosed were analyzed. Results 3 cases onset from lower limb weakness,spread to pectoral limb or opposite side,dorsal spine MRI:compression of meninx fibrosia, after operation, symptoms was not relieve and pathogenetic condition was aggravating, ALS was confirmed hy electromyogram( EMG ). Conclusion It is linchpin for clinician to avoid misdiagnosis of ALS,particularly asking medical record , seriously medical examination,to make use of electrophysiologic study( EPS ).%目的 掌握肌萎缩侧索硬化(ALS)的诊断标准,以便早期准确诊断,避免误诊.方法 分析3 例ALS患者早期被误诊的临床资料.结果 3例患者均以下肢无力发病,逐渐波及上肢或对侧肢体,脊柱MRI示颈部或腰部椎间盘突出压迫硬膜囊,手术治疗后,症状无缓解,病情仍进行性加重,经肌电图检查证实为ALS.结论 临床医师应熟知ALS的诊断标准,对患者详细询问病史、认真查体和电生理检查是减少ALS误诊的关键.