摘要
目的探讨以癫痫发作为表现的神经梅毒患者的临床特征.方法回顾分析2014年8月至2019年5月就诊于首都医科大学附属北京地坛医院神经内科表现为癫痫发作的21例神经梅毒患者的临床特点及脑电图、影像学资料.结果入组患者男性占数量优势(20例);14例为局灶起源的发作(其中9例由局灶扩散至双侧强直-阵挛发作),4例为未知起源的强直-阵挛发作,1例为未知起源的惊厥性癫痫持续状态,2例仅于脑电图见到痫性波而无临床发作.14例患者为麻痹型痴呆,其余为脑膜脑炎型(4例)、脑膜血管型(2例)及树胶肿型(1例).患者癫痫发作间期脑电图表现为慢波节律、癫痫波、蝶骨电极位相倒置或正常.共随访16例患者,其中10例无癫痫发作.结论以癫痫发作及精神症状为表现的患者,需要考虑神经梅毒,早期发现及积极驱梅治疗可改善预后.
Objective To investigate the clinical charateristics of neurosyphilis presenting with epileptic seizures. Methods Clinical, imaging and electroencephalogram (EEG) data of 21 patients of neurosyphilis presenting with seizures and admitted by the Department of Neurology in Beijing Ditan Hospital, Capital Medical University from August 2014 to May 2019 were analyzed, retrospectively. Results The number (20 patients) of men in the enrolled patients had a superiority;there were 14 patients with local onset seizures (9 patients among whom with local to bilateral tonic-clonic seizures), 4 patients with unknown onset tonic-clonic seizures, 1 patient with convulsive status epilepticus and unknown source, 2 patients with manifest electrographic seizure only. Forteen patients were paralytic dementia, the rest were meningeal meningitis type (4 patients), meningeal vascular type (2 patients) and gum type (1 patients). The interictal EEG showed slow wave rhythm, epileptic wave and sphenoid electrode phase inversion or normal. A total of 16 patients were followed up, 10 patients among whom had no seizures. Conclusions Among the manifestation of patients with epileptic seizures and mental symptoms, neurosyphilis should be considered in diagnosis. Early detection and active treatment could improve the prognosis.
作者
秦开宇
闫铄
伍文清
黄宇明
许东梅
马小扬
吴雅丽
寇程
苗冉
Qin Kaiyu;Yan Shuo;Wu Wenqing;Huang Yuming;Xu Dongmei;Ma Xiaoyang;Wu Yali;Kou Cheng;Miao Ran(Department of Neurology,Beijing Ditan Hospital,Capital Medical University,Beijing 1000151;Department of Radiology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2019年第4期348-351,共4页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
感染病科国家临床重点专科建设项目
关键词
癫痫性发作
神经梅毒
临床特征
Epileptic seizure
Neurosyphilis
Clinical characteristics
作者简介
通信作者:伍文清,Email:ruiyang56@aliyun.com.
