精神障碍为主要临床相的病毒性脑炎28例临床分析

摘要

Objective To investigate the clinical features of viral encephalitis which mainly presented as psychiatric disorder. Methods 28 cases of patients with viral encephalitis manifested as psychiatric disorder from January 2007 to December 2010 were retrospectively analyzed. Results The early misdiagnosis rate of viral encephalitis characterized by mental disorders was 39. 29% , and patients were easily misdiagnosed as schizophreniform psychosis or other mental disorders. Conclusion The early symptoms of part of the patients with viral encephalitis was psychiatric disorder, which may even become the main clinical feature, are often accompanied with conscious disturbance, psychomotor excitement or retardation, convulsive seizures and mental retardation. Disease histoiy,electroencephalography,cerebrospinal fluid, and cranial CT scan examination all contribute to the early diagnosis and treatment.%目的 探讨精神障碍为主要临床相的病毒性脑炎的临床特点.方法 对我科2007年1月至2010年12月收住的28例以精神障碍为主要临床相的病毒性脑炎的临床资料进行回顾性分析.结果 病毒性脑炎以精神障碍为主要临床表现者早期误诊率达39.29%,极容易误诊为分裂样精神病或其他精神障碍.结论 病毒性脑炎的患者中部分以精神障碍为首发症状,甚至是主要临床相,常伴有意识障碍,精神运动性兴奋或抑制,抽搐发作和智能障碍.在诊断的过程中应该结合病史、脑电图、脑脊液、头颅CT作出早期诊断和治疗.