摘要
目的提高对误诊为缺血性脑卒中的代谢性脑病的识别度,降低代谢性脑病的临床误诊率。方法回顾性分析2018年1月—2020年12月初诊为缺血性脑卒中后证实为代谢性脑病3例的临床资料。结果3例均以意识障碍或肢体活动不利等卒中样发作起病,病初均诊断为缺血性脑卒中,后经过详细问诊、完善的实验室检查、影像学支持及基因检测确诊为代谢性相关肝性脑病1例、线粒体脑肌病伴高乳酸血症和脑卒中疾病样发作1例、高钙血症相关卒中模拟病1例。经对症治疗后3例症状均得到改善。结论代谢性脑病可出现卒中样表现,临床可与缺血性脑卒中混淆。全面分析临床资料、完善相关实验室检查和MRI评估对于提高代谢性脑病诊断正确率至关重要。
Objective To improve the recognition of metabolic encephalopathy misdiagnosed as stroke and to reduce the clinical misdiagnosis rate of metabolic encephalopathy.Methods From January 2018 to December 2020,the clinical data of 3 patients misdiagnosed with ischemic stroke and confirmed as metabolic encephalopathy were retrospectively analyzed.Results All the 3 cases were diagnosed as ischemic stroke at the beginning by the strok-like attack such as disturbance of consciousness or poor limb movement.After detailed inquiry,complete laboratory examination,imaging support and genetic testing,1 case was confirmed as metabolic-related hepatic encephalopathy,1 case as mitochondrial encephalomyopathy with hyperlactemia and stroke disease like attack,and 1 case as hypercalcemia-related stroke simulation.All the symptoms were improved after symptomatic treatment.Conclusion Metabolic encephalopathy may present apoplexy like manifestations,which can be confused with ischemic stroke in clinical practice.Comprehensive analysis of clinical data,improvement of relevant laboratory examination and MRI evaluation are of great significance to improve the diagnostic accuracy of metabolic encephalopathy.
作者
韩静瑜
王黎萍
朱朝阳
HAN Jing-yu;WANG Li-ping;ZHU Chao-yang(School of Medicine,Shaoxing University of Arts and Sciences,Shaoxing,Zhejiang 312000,China;Department of Neurology,the People's Hospital of Shaoxing City,Shaoxing,Zhejiang 312000,China)
出处
《临床误诊误治》
CAS
2023年第1期26-29,共4页
Clinical Misdiagnosis & Mistherapy
关键词
代谢性脑病
卒中模拟病
误诊
肝性脑病
线粒体脑肌病伴高乳酸血症和脑卒中疾病样发作
高钙血症
Metabolic encephalopathy
Apoplexy simulator
Misdiagnosis
Hepatic encephalopathy
Mitochondrial encephalomyopathy with hyperlactemia and stroke-like attack
Hypercalcemia
