TY -乔的T1 -亚当摩根富林明神经病学神经病学首页SP - 1257 LP - 1260 - 10.1212 / WNL.56.10.1257六世- 56 - 10 AU -汉斯哈Y1 - 2001/05/22 UR - //www.ez-admanager.com/content/56/10/1257.abstract N2 -急性播散性脑脊髓炎(ADEM)是一种罕见的中枢神经系统炎性脱髓鞘疾病影响主要是儿童和年轻人。通常,它是先于的传染性疾病,最常见的麻疹、流行性腮腺炎、流感A或B,落基山斑疹热,或A或B型肝炎,或感染单纯疱疹,人类疱疹病毒6、水痘、风疹、牛痘,巴尔病毒、巨细胞病毒、肺炎支原体、衣原体、军团菌、弯曲杆菌、链球菌。亚当也可以遵循免疫:狂犬病,三级白喉-破伤风-百日咳,天花、麻疹、流行性乙型脑炎和猪。1、2⇓特点临床特征包括突然发生的多焦点的神经紊乱如双边视神经炎、视野缺损、失语,运动和感觉赤字,共济失调,运动障碍,并与假性脑膜炎急性meningoencephalopathy的迹象,一个沮丧的意识水平,焦或广义癫痫,精神病。最大的赤字和缓解可能几天内达到同样迅速。更常见的是,然而,解决部分和需要数周或数月。高死亡率(20%)是频繁的在过去,特别是当ADEM麻疹。然而,通过引入有效的疫苗接种战略和麻疹的衰落,死亡是罕见的。2 MRI显示多病灶的地区增加信号强度在t2加权序列,通常与对比剂增强同步。3、4⇓广泛病灶周边水肿可能见过。白质参与主导但灰质也受到影响,特别是基底神经节,花托和脑干。 Lesions may also be restricted to the brainstem or cerebellum. Tumor-like lesions also occur. CSF usually shows pleocytosis but only rarely intrathecal oligoclonal immunoglobulin (Ig) G production, which almost invariably ceases as patients improve. Whereas high-dose steroids, plasma exchange, IVIg, immunomodulators, and hypothermia have been tried, no treatment is established.5-9⇓⇓⇓⇓ This textbook view of ADEM is based on a compilation of features extracted from single cases and small … ER -