中国全科医学2012，Vol.15Issue(26)：3034-3035,3038,3.DOI:10.3969/j.issn.1007-9572.2012.09.055
脊髓痨的临床特点及误诊原因分析
Clinical Features of Myelophisis and Its Misdiagnosis: Report of 4 Cases and Literature Review
吴哲 1柳忠兰 1韩学艳 2付贺飞 1李岩 1罗小萌3
作者信息
- 1. 110001,辽宁省沈阳市,中国医科大学附属第一医院神经内科
- 2. 阜新市中心医院神经内科
- 3. 中国医科大学七年制95期3班
- 折叠
摘要
Abstract
Objective To summarize the clinical manifestations of myelophthisis and analyze the reasons of misdiagnosis. Methods We retrospectively analyzed the clinical data of 4 patients with myelophthisis in our hospital. Meanwhile, the data of 23 patients who were previously reported in Chinese literature were reviewed and compared with foreign literature. Results All these 4 patients in our hospital presented with walking unsteadiness, attenuated or missing knee reflex, and Romberg's sign, which were consistent with international literature. Among these 27 Chinese patients, 13 presented with fulgurate and needling pain, 9 with disturbance of micturition, 5 with Argyll - Robertson pupil. No visceral crisis or nutritional disturbance was observed. Eleven patients presented with peripheral sensation abnormality and 15 with limbs anesthesia. Other findings included lancinating pain of the lower limbs ( n = 2 ), voiding dysfunction ( n = 2 ), binocular vision loss ( n = 1 , with congenital syphilis ), bilateral optic atrophy ( n = 1 ), reduced vision ( tunnel vision ) ( n = 1 ), Argyll - Robertson pupil ( n = 1 ), anisocoria ( n = 2 ), facial palsy ( n =2 ), and elevated cerebrospinal fluid cell count ( n =2 ). Conclusion Chinese patients with myelophthisis tend to be presented with " untypical" manifestation, which may be mainly due to short course of disease and subsequently the lack of typical clinical manifestations. These " atypical" clinical manifestations can easily result in misdiagnosis and missed diagnosis. Therefore, serum and cerebralspinal fulid tests for syphilis should be performed for patients who are presented with ataxia, disturbance of deep sensation, and Romberg's sign.关键词
脊髓痨/临床特点/误诊/神经梅毒Key words
Tabes dorsalis/ Clinical characteristics/ Diagnostic errors/ Neurosyphilis分类
医药卫生引用本文复制引用
吴哲,柳忠兰,韩学艳,付贺飞,李岩,罗小萌..脊髓痨的临床特点及误诊原因分析[J].中国全科医学,2012,15(26):3034-3035,3038,3.
