可逆性后部白质脑病综合征的临床分析

摘要

目的：分析可逆性后部白质脑病综合征（RPLS）的病因、临床特点及治疗方法，提高临床对本病的认识。方法回顾性分析我院12例RPLS患者的临床资料，重点研究患者的临床表现、脑脊液（CSF）及影像学相关资料。结果本组患者均发病急骤，其中以头痛及癫痫发作为首发症状。颅脑MRI表现为颅内长T1长T2信号，FLAIR像呈高信号，病变累及脑白质为主、脑皮质亦可受累。对确诊患者立刻实行降颅压改善脑水肿、抗癫痫治疗并针对不同病因采用不同的针对性治疗。经合理有效的对症治疗，本组患者的临床症状及影像学表现均在短期内明显好转或完全恢复、顺利出院。结论本病发病急骤，早期明确诊断十分重要，同时由于RPLS具有可逆性，因此科学有效的治疗可使患者的临床体征及影像学表现恢复至正常水平。%Objective To analyze the causes of reversible posterior white matter disease syndrome (RPLS), clinical characteristics and treatment methods, improve the clinical understanding of the disease. Methods Retrospective analysis the clinical data of 12 cases of RPLS, focuses on the patient's clinical manifestations, cerebrospinal fluid (CSF) and imaging data. Results The patients were rapid disease, among them with headache and epilepsy hair as the first symptoms;Cerebral MRI performance for intracranial long T1 long T2 signals, FLAIR like show high signal, lesions involving the cerebral white matter is given priority to, the cerebral cortex can be affected;Implemented immediately in patients with diagnosis of intracraninal pressure to improve cerebral edema, antiepileptic treatment and different pathogeny according to the different specific therapy. The reasonable effective symptomatic treatment, the patients clinical symptoms and imaging findings are improved significantly in a short time or fully recovered and discharged smoothly. Conclusion The disease pathogenesis, early diagnosis is very important, at the same time because RPLS is reversible, therefore, scientific and effective treatment can make the patient's clinical signs and imaging findings back to normal levels.