CAJ | 학술논문

目的：分析4例以短暂性脑缺血发作起病的神经梅毒的临床特点及诊断、治疗方法。方法回顾我院2006年7月~2013年11月4例神经梅毒患者的临床特点、血清及脑脊液检查和神经影像学检查结果。结果患者年龄26~42岁,平均33.75岁。患者TIA症状中肢体无力3例,构音障碍2例,面瘫1例,肢体麻木1例。在TIA症状出现的同时或稍后4例出现智能减退,2例出现眼部症状,1例出现精神症状。CSF白细胞数轻度增加、蛋白水平高于正常。血及脑脊液RPR3例阳性,TPPA4例阳性。头MRI示轻度的脑萎缩,以颞叶为主,可有异常信号。颅内外血管可正常,可有局灶性或弥漫性狭窄。结论神经梅毒的发病率呈逐年上升趋势,但其临床表现复杂多变,易误诊和漏诊,是青年卒中的又一重要因素。
목적：분석4례이단잠성뇌결혈발작기병적신경매독적림상특점급진단、치료방법。방법회고아원2006년7월~2013년11월4례신경매독환자적림상특점、혈청급뇌척액검사화신경영상학검사결과。결과환자년령26~42세,평균33.75세。환자TIA증상중지체무력3례,구음장애2례,면탄1례,지체마목1례。재TIA증상출현적동시혹초후4례출현지능감퇴,2례출현안부증상,1례출현정신증상。CSF백세포수경도증가、단백수평고우정상。혈급뇌척액RPR3례양성,TPPA4례양성。두MRI시경도적뇌위축,이섭협위주,가유이상신호。로내외혈관가정상,가유국조성혹미만성협착。결론신경매독적발병솔정축년상승추세,단기림상표현복잡다변,역오진화루진,시청년졸중적우일중요인소。
Objective To analyze the clinical characteristics, diagnosis and treatment of four case neurosyphilis with transient ischemic at ack onset.Methods Review the clinical characteristics,blood and CSF examination and neuroimaging results of four patients with neurosyphilis in our hospital from July 2006 to November 2013. Results The ages of patients were between 26 and 42 years ( average 33.75 years).TIA symptoms show limb weakness (3 cases),dysarthria (2 cases),facial paralysis (1 case) and numbness(1 case). Patients show mental decline(4 cases), ocular symptoms(2cases),and psychiatric symptoms(1 case) at the same time or later after TIA. Leukocyte counts and protein levels in CSF were increased.3cases in RPR and 4 cases in TPPA of blood and CSF were positive. MRI showed mild cerebral atrophy,which focus on temporal lobe,and may have abnormal signal. Intracranial vascular may be normal ,also may have focal or dif use stenosis. Conclusion The incidence of neurosyphilis showed an increasing trend.The clinical characteristics of neurosyphilis are complex, which easily lead to misdiagnosis and missed diagnosis.Neurosyphilis is another important factor in young stroke.