以孤立性眩晕为临床表现的颅内炎性脱髓鞘2例报道

Clinical anlysis of intracranial inflammatory demyelinating diseases manifested as isolated vertigo in two patients

摘要:

目的 分析2例表现为孤立性眩晕的颅内炎性脱髓鞘病的临床特点，提高临床医生对其认识，为中枢性和周围性孤立性眩晕患者的诊疗提供帮助。方法 对2例表现为孤立性眩晕患者的病史、体格检查、辅助检查及治疗过程进行分析总结。结果 2例患者均表现为急性孤立性眩晕，1例患者有上呼吸道感染史，1例患者可诱发出无疲劳性位置性眼震。2例患者的神经系统、听力及前庭功能检查均未见异常，头颅MRI示：脑干或小脑可见异常信号。使用激素冲击治疗，2例患者预后较好。结论 急诊孤立性眩晕疾病需尽早排除中枢性疾病。

Abstract:

Objective To analyze the clinical characteristics of intracranial inflammatory demyelinating diseases manifested as isolated vertigo in 2 cases for improving the disease awareness and levels of diagnosis and treatment of central and peripheral isolated vertigo. Methods The history, physical examination, auxiliary examinations and treatment of 2 patients with isolated vertigo were analyzed and summarized. Results Both patients suffered from acute isolated vertigo. One patient had previous history of upper respiratory infection and another case showed non-fatigue positional nystagmus. Both the two patients showed normal results of neurological system, hearing and vestibular functions, but abnormal signals of brainstem or cerebellum in magnetic resonance imaging (MRI). Steroid pulse therapy was adopted in both patients with good prognosis. Conclusion Diseases of central nervous system should be excluded in acute isolated vertigo as soon as possible.