中国现代神经疾病杂志最新文献

{"title":"Research progress on risk factors for recurrent ischemic stroke","authors":"X. Hao, Shicheng Yu","doi":"10.3969/CJCNN.V17I10.1678","DOIUrl":"https://doi.org/10.3969/CJCNN.V17I10.1678","url":null,"abstract":"Ischemic stroke has a high disability rate, mortality and recurrence rate. The term of recurrent ischemic stroke is patient's conditions occur again after improvement or recovery of ischemic stroke. The disability rate and mortality of recurrent ischemic stroke will be significantly higher than those after the first onset. In this paper, the related risk factors for recurrent ischemic stroke were reviewed to provide the basis of secondary prevention for ischemic stroke, and to reduce the incidence of recurrent ischemic stroke. DOI: 10.3969/j.issn.1672-6731.2017.10.011","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"765-770"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42131216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI combined with 18F -FDG PET and 11C -MET PET in differentiating tumefactive demyelinating lesion and glioma","authors":"Yihan Yang, L. Cai, Haiwen Ma, Ying Wang, Yu-zhen Bai, Hao-lang Ming, Sheng-ping Yu, Bingcheng Ren, Yu Lin, Kai Zhang, Long Hai, Wen Wang, Cheng Cheng, Tao Li, Xuejun Yang","doi":"10.3969/cjcnn.v17i10.1680","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1680","url":null,"abstract":"Objective To explore the value of MRI combined with 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) PET and 11 C-methionine ( 11 C-MET) PET on differentiating tumefactive demyelinating lesion (TDL) and glioma. Methods Fourteen cases of TDL and 17 cases of glioma were confirmed by pathology directly or internal medicine treatment. MRI was used to observe the lesion boundary, T 1 WI, T 2 WI and diffusion - weighted imaging (DWI) signal intensity, enhancement (including ring enhancement and open - ring enhancement, etc.), mass effect, peripheral edema, and the presence of central venectasia, corpus callosum engagement, central necrosis and gray matter engagement. 18 F-FDG PET and 11 C-MET PET were used to calculate relative uptake values.  Results Among all TDL cases, MRI showed that mass effect of 8 cases (8/14) were grade 0, 4 cases (4/14) gradeⅠ, one case (1/14) was gradeⅡ and one case (1/14) gradeⅢ; the peripheral edema of 12 cases (12/14) were gradeⅠand 2 cases (2/14) gradeⅡ. Among all glioma cases, the mass effect of 2 cases (2/17) were grade 0, 6 cases (6/17) gradeⅠ, 7 cases (7/17) gradeⅡand 2 cases (2/17) grade Ⅲ; the peripheral edema of 7 cases (7/17) were grade Ⅰ and 10 cases (10/17) grade Ⅱ. The differences between TDL and glioma were statistically significant (Fisher's exact probability: P = 0.032, 0.024). 18 F-FDG PET and 11 C-MET PET were not statistically significant in differentiating TDL and glioma (Fisher's exact probability: P = 0.182, 0.081).  Conclusions Mass effect and peripheral edema showed in MRI can be used for the differential diagnosis of TDL and glioma. The value of PET-CT in differentiating TDL and glioma is unsure. DOI: 10.3969/j.issn.1672-6731.2017.10.009","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"754-761"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46161840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of efficacy of continuous positive airway pressure in treatment of epilepsy with obstructive sleep apnea syndrome","authors":"Yu Zhang, Deng Chen, Lina Zhu, Da Xu, Haijiao Wang, Ling Liu","doi":"10.3969/CJCNN.V17I10.1673","DOIUrl":"https://doi.org/10.3969/CJCNN.V17I10.1673","url":null,"abstract":"Objective To evaluate the efficacy of continuous positive airway pressure (CPAP) ventilation treatment for epilepsy with obstructive sleep apnea syndrome (OSAS). Methods The data were collected from the following words: sleep apnoea, obstructive sleep apnoea, OSA, obstructive sleep apnoea syndrome, OSAS, sleep apnoea syndromes, sleep-related breathing disorder, epilepsy, continuous positive airway pressure, CPAP. PubMed, EMBASE/SCOPUS and Cochrane Library retrieval on randomized controlled clinical trials, clinical guidelines, systematic review (including Meta-analysis), case controlled studies and retrospective cohort studies of CPAP ventilation treatment of epilepsy with OSAS from January 1, 1980 to February 28, 2017. Jadad Scale, Cochrane System Evaluation Handbook and RevMan 5.3 software were used for quality assessment and Meta-analysis. Results A total of 1197 English literatures were obtained, and 17 English articles were included in the study, including one clinical guideline, one systematic review, one Meta-analysis, one randomized controlled clinical trial, 10 case controlled studies and 3 retrospective cohort studies. The results showed that: 1) CPAP ventilation treatment can decrease the seizure frequency or even emarge seizure free in epilepsy with OSAS. 2) CPAP ventilation treatment can reduce the seizure frequency of refractory epilepsy with OSAS. 3) CPAP ventilation treatment can reduce the seizure frequency of elderly epilepsy patients with OSAS. 4) Meta-analysis on three clinical studies (153 epilepsy and OSAS patients) with Jadad ≥ 4 scores showed cases with reduction seizure frequency > 50% in CPAP group were more than those in unused CPAP group ( RR = 3.170, 95%CI: 1.650-6.090; P = 0.001).  Conclusions CPAP ventilation treatment can reduce the seizure frequency of patients with epilepsy and OSAS. The effect of treatment depends on patients compliance. Sudden drug-withdrawl or pressure insuffiency may increase seizure frequency. This conclusion remains to be confirmed. DOI: 10.3969/j.issn.1672-6731.2017.10.005","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"728-735"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42215794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A few thoughts on the current situation of neurosurgery spinal subspecialty residency training","authors":"Zan Chen, Xing-hua Zhao, Zhi-yuan Xia","doi":"10.3969/cjcnn.v17i10.1677","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1677","url":null,"abstract":"Spinal department of neurosurgery develops in an all-round way in many European and American countries. The amount spinal surgery can reach half of all the department of neurosurgery surgery. It can be seen that spinal department of neurosurgery has huge development potential. Because of historical reasons, department of neurosurgery in China is less involved in the treatment of spinal and spinal cord diseases, and the diagnosis and treatment techniques in related fields are relatively backward. It is urgent to develop the spinal department of neurosurgery in China, whereas the bottleneck is talent training and reserve. This training program of spinal department of neurosurgery talent development intends to solve this problem. DOI: 10.3969/j.issn.1672-6731.2017.10.010","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"762-764"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48667222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on rapid eye movement sleep behavior disorder in patients with Parkinson's disease at early stage","authors":"Hui-li Zou, Xianchao Zhao, Yingcong Jiang, Ge-sheng Lei, Weiyi Yang, C. Su","doi":"10.3969/cjcnn.v17i10.1674","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1674","url":null,"abstract":"Objective To investigate the incidence, occurrence time and electrophysiological characteristics of rapid eye movement behavior disorder (RBD) in patients with early Parkinson's disease (PD), and the characteristics of motor symptoms and non . motor symtoms (NMS). Methods Sixty PD patients were divided into PD + RBD group (N = 42) and control group (N = 18) according to whether they were complicated with RBD or not. Unified Parkinson's Disease Rating Scale (UPDRS)Ⅱ andⅢ, Hoehn-Yahr Stage, Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), RBD Screening Questionnaire (RBDSQ), Epworth Sleepiness Scale (ESS) and polysomnography (PSG) were used in 60 patients.  Results Among 60 patients, 42 (70% ) were accompanied by RBD. PSG showed that PD + RBD patients mainly presented upper limb stretching and gripping, body twitching, laughing, shouting, cursing and other non.violent actions, except 2 cases presented violent actions, such as hitting, kicking, etc. In PD + RBD group, the age was older (P = 0.024), duration was longer (P = 0.000), and UPDRSⅡ (P = 0.005)，UPDRSⅢ(P = 0.001), the scale values of Hoehn-Yahr Sotage 2 (P = 0.007), anxiety (P = 0.044) and depression (P = 0.001) ratio were all higher than control group. There were significant differences in density of mandible myoelectric activity (P = 0.000) and ratio of rapid eye movement (REM) without atonia (P = 0.000) between 2 groups. In PD + RBD group, 16 patients (38.10% ) had symptoms of RBD, earlier than PD occurred 5.20 (3.91, 6.51) years.  Conclusions PD patients with older age, longer duration, more severe motor symptoms and non?motor symptoms were more likely to be accompanied by RBD. The severity of RBD in PD patients accompanied with RBD is higher than that in PD without RBD. RBD may be the early manifestation of PD. PSG has important value in the diagnosis of PD with RBD. DOI: 10.3969/j.issn.1672-6731.2017.10.006","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"736-740"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46120565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoimmune encephalitis and sleep disorders","authors":"Y. Huang, Hong-lin Hao","doi":"10.3969/cjcnn.v17i10.1672","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1672","url":null,"abstract":"Research shows that autoimmune encephalitis is associated with sleep disorders. Paraneoplastic neurological syndrome (PNS) with Ma2 antibodies can cause sleep disorders, particularly narcolepsy and rapid eye movement sleep behavior disorder (RBD). Limbic encephalitis (LE) and Morvan syndrome, associated with voltage - gated potassium channel (VGKC)-complex antibodies, which include leucine-rich glioma-inactivated 1 (LGI1) antibody and contactin-associated protein 2 (Caspr2), can result in profound insomnia and other sleep disorders. Central neurogenic hypoventilation are found in patients with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, whereas obstructive sleep apnea (OSA), stridor and parasomnia are prominent features of encephalopathy associated with IgLON5 antibodies. Sleep disorders are cardinal manifestations in patients with autoimmune encephalitis. Immunotherapy possiblely can improve clinical symptoms and prognosis in a positive way. DOI: 10.3969/j.issn.1672-6731.2017.10.004","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"723-727"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46206698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress on the pathogenesis of rapid eye movement sleep behavior disorder and neurodegenerative diseases","authors":"Haiyang Jiang, Jinsha Huang, Tao Wang","doi":"10.3969/cjcnn.v17i10.1671","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1671","url":null,"abstract":"Rapid eye movement sleep behavior disorder (RBD) is a sleep disorder characterized by the disappearance of muscle relaxation and enacting one's dreams during rapid eye movement (REM), with most of the dreams being violent or aggressive. Prevalence of RBD, based on population, is 0.38%-2.01%, but it becomes much higher in patients with neurodegenerative diseases, especially α - synucleinopathies. RBD may herald the emergence of α-synucleinopathies by decades, thus it may be used as an effective early marker of neurodegenerative diseases. In this review, we summarized the progress on the pathogenesis of RBD and its relationship with neurodegenerative diseases. DOI: 10.3969/j.issn.1672-6731.2017.10.003","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"717-722"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46664599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focus on interoperation between sleep medicine and neurology","authors":"F. Han, F. Xiao","doi":"10.3969/CJCNN.V17I10.1669","DOIUrl":"https://doi.org/10.3969/CJCNN.V17I10.1669","url":null,"abstract":"Focus on interoperation between sleep medicine and neurology HAN Fang, XIAO Fu⁃long Sleep Medicine Center, Department of Respiratory Medicine, Peking University People's Hospital, Beijing 100044, China Corresponding author: HAN Fang (Email: hanfang1@hotmail.com) This study was supported by the National Basic Research Development Program of China (973 Program, No. 2015CB856405) and Key International (Regional) Cooperation Program of National Natural Science Foundation of China (No. 81420108002). ·专论·","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"705-707"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49528362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of sleep dysfunction and sleep - disordered breathing in amyotrophic lateral sclerosis patients","authors":"F. Wang, Zhaoyang Huang, Yan Ding, Ning Li, Yuping Wang, S. Zhan","doi":"10.3969/cjcnn.v17i10.1675","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1675","url":null,"abstract":"Objective To study the characteristics of sleep architecture and sleep - disordered breathing (SDB) in patients with amyotrophic lateral sclerosis (ALS) using polysomnography (PSG). Methods A total of 36 patients with ALS were recruited in this study. According to symptoms of medulla oblongata, the patients were divided into limb involvement group (N = 14) and bulbar palsy group (N = 22). Detailed record of the patients was made including general information and chief complaints of sleep dysfunction and SDB, which covered sleep initiation and maintenance disorders, arousals, difficulty in breathing and snoring, nocturnal polyuria, restless legs syndrome (RLS) and muscle soreness. Appel Amyotrophic Lateral Sclerosis (AALS) Scores were used to assess bulbar function, breathing function,myodynamia and limbs function. PSG was performed to monitor EEG, EOG, EMG, ECG, position, snore, gas flow of mouth and nose, chest breathing, pulse oxygen saturation (SpO 2 ) and sleep-related parameters including total sleep time (TST), sleep efficiency (SE), sleep latency (SL), awakening times, percentage of different non-rapid eye movement (NREM) and rapial eye movement (REM), and apnea hypopnea index (AHI). Pearson correlation analysis evaluated the relationship between AHI of REM, periodic limb movements (PLM) and clinical information, AALS Scores. Results Bulbar palsy group had higher scores in AALS Scores ( P = 0.007), bulbar function ( P = 0.000) and breathing function ( P = 0.000), and lower score in upper limb myodynamia ( P = 0.016) than limb involvement group. Both 2 groups showed disturbed sleep architecture in the performance of sleep fragmentation. Bulbar palsy group had more awakening times ( P = 0.027), lower percentage of REM sleep ( P = 0.009) and less PLM ( P = 0.020) than limb involvement group. The main respiratory event of 2 groups was hypopnea. Bulbar palsy group had higher AHI (P = 0.038) and AHI of REM and NREM ( P = 0.031, 0.049) than limb involvement group. Pearson correlation analysis showed that AHI of REM was positively correlated with duration ( r = 0.654, P = 0.028), AALS total score ( r = 0.458, P = 0.034), bulbar function score ( r = 0.572, P = 0.030) and breathing function ( r = 0.756, P = 0.002). PLM was also positively correlated with duration ( r = 0.574, P = 0.030), AALS total score ( r = 0.321, P = 0.042), upper limb function ( r = 0.656, P = 0.028) and lower limb function ( r = 0.754, P = 0.015). Conclusions Patients with ALS have many types of sleep disorders including insomnia, SDB and periodic limb movements disorder (PLMD). PSG can monitor respiratory event thus providing clinical evidence for the non-invasive ventilation intervention. DOI: 10.3969/j.issn.1672-6731.2017.10.007","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"741-747"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46562450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fever hepatosplenomegaly weakness of lower limbs","authors":"L. Ding, Lin Wang, Mingsheng Liu, B. Peng, L. Cui","doi":"10.3969/CJCNN.V17I10.1681","DOIUrl":"https://doi.org/10.3969/CJCNN.V17I10.1681","url":null,"abstract":"患者 女性,22 岁。主因反复发热 1 年余,双下肢无力 20 余天,于 2016 年 10 月 26 日入我院。患者于 1 年余前 (2015 年 5 月)无明显诱因出现反复发热,体温最高达 40 °C, 外院实验室检查:血常规白细胞计数为 1.04 × 10 9/L[(3.50 ~ 9.50)× 10 9/L],网织红细胞比例 0.0145(0.80 ~ 2.00),血红蛋 白 92 g/L(110 ~ 150 g/L),血小板计数为 72 × 10 9/L[(100 ~ 350)× 10 9/L];外周血 EB 病毒 DNA 测定 416 × 10 3 拷贝/ml; 腹部超声显示,肝右斜径 16.10 cm,门静脉内径 1.30 cm,脾门 处脾厚 7.40 cm,脾静脉内径 1 cm,侧卧位脾肋下 16 cm、平卧 位脾过中线 5 cm,提示肝脏肿大,肝实质弥漫性改变,巨脾, 门静脉系统轻度扩张;胸部 CT 显示双肺多发性结节影,提示 炎症性改变;骨髓细胞学检查可见三系增生骨髓象,红系比 例增加;骨髓活检提示骨髓增生大致正常,三系增生伴巨核 细胞形态轻度异常;JAK2 V617F 定量 0%,CALR Exon9 和 MPL Exon10 突变阴性;流式细胞术显示,粒系比例增加,出 现核左移,CD13 表达下调;免疫组织化学染色,CD41+巨核细 胞计数 1391 个,其中正常巨核细胞计数 1238 个,中性粒细 胞碱性磷酸酶(NAP)和糖原高碘酸⁃雪夫(PAS)染色阴性,铁 粒幼细胞阳性率为 2%(27% ~ 94%)。临床考虑 EB 病毒感 染,遂予以抗感染、保护肝脏和静脉注射免疫球蛋白(具体方 案不详)治疗,2 个月后发热症状逐渐缓解。此后定期复查 血常规显示全血细胞计数减少;腹部超声显示,肝脾大,门静 脉系统持续扩张。患者 20 余天前无明显诱因出现双下肢无 力,行走时双下肢沉重、僵硬,症状进行性加重;14 d 前需搀 扶行走,不能自行蹲起,偶有跌倒;7 d 前症状略减轻,病程中 无头晕、头痛,无恶心、呕吐,无视物模糊、视物成双,无言语 不清、饮水呛咳,无肢体麻木,无大小便障碍。外院胸椎 MRI 检查(2016 年 10 月 19 日)显示,胸髓内弥漫性斑片状异常信 号影,考虑炎性脱髓鞘病变可能。为求进一步诊断与治疗, 至我院就诊,门诊以“脊髓病变”收入院。患者自发病以来, 精神、睡眠、饮食尚可,大小便正常,体重无明显减轻,否认眼 干、口干、脱发、皮疹、关节肿痛和雷诺现象等免疫色彩。 既往史、个人史及家族史均无特殊。 入院后体格检查 患者体温 37.2 °C,脉搏 80 次/min,呼 吸 23 次/min,血压 105/64 mm Hg(1 mm Hg = 0.133 kPa)。右 侧颌下触及 1 个小淋巴结,黄豆大小,活动度可,质地坚韧, 无压痛。腹部柔软,无压痛,肝脏肋下未触及,脾大,肋下约 8 cm。神经系统检查:神志清楚,语言流利,视力、视野粗测 正常,双侧瞳孔等大、等圆,直径约 4 mm,对光反射灵敏,余 脑神经未见异常;双上肢肌力 5 级、肌张力正常,双下肢肌力 5-级、肌张力增高;针刺觉、音叉震动觉正常;双侧指鼻试验、 快复轮替动作和跟⁃膝⁃胫试验稳准;四肢腱反射活跃;右侧 Hoffmann 征阳性、左侧阴性,双侧 Rossolimo 征阳性,双侧 Babinski 征 阳 性 、Chaddock 征 阳 性 ,双 侧 踝 阵 挛 阳 性 , Romberg 征阴性;呈痉挛步态;脑膜刺激征阴性。神经心理 学测验:简易智能状态检查量表(MMSE)评分 24 分,蒙特利 尔认知评价量表(MoCA)评分 23 分。 辅助检查 实验室检查:血常规白细胞计数 0.80×10 9/L、 中性粒细胞计数 0.49 × 10 9/L[(2.00 ~ 7.50)× 10 9/L],网织红 细胞计数 99.70 × 10 9/L[(24 ~ 84)× 10 9/L]、网织红细胞比例 0.0241,血红蛋白 114 g/L,血小板计数 45 × 10 9/L,红细胞沉降 率(ESR)2 mm/h(0 ~ 20 mm/h);血涂片:红细胞大小轻度不 等,白细胞形态大致正常,血小板少见。血液化学总胆红素 26.50 μmol/L(5.10 ~ 22.20 μmol/L),直接胆红素 10.40 μmol/L 发热 肝脾大 双下肢无力","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"771-775"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44869087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}