颜谈,王幼萌,许静,等.伴两侧面部及同侧下肢麻木的 Wallenberg综合征 1例并文献复习[J].安徽医药,2022,26(10):2001-2004. |
伴两侧面部及同侧下肢麻木的 Wallenberg综合征 1例并文献复习 |
Wallenberg syndrome with bilateral facial and ipsilateral lower extremities numbness: a case report and literature review |
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DOI:10.3969/j.issn.1009-6469.2022.10.022 |
中文关键词: 延髓外侧综合征 感觉障碍 血栓溶解疗法 机制 |
英文关键词: Lateral medullary syndrome Sensory disorder Thrombolytic therapy Mechanisms Wallenberg |
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中文摘要: |
目的分享 1例极少见的 Wallenberg综合征的变异型(两侧面部及同侧下肢麻木)病人,为大家的医疗诊治给予一定的帮助。方法回顾性分析 2019年 6月 1日阜阳市人民医院收治的 1例延髓背外侧梗死病人的病因、机制、症状体征、检验检查、用药情况及治疗效果等,参阅各种 Wallenberg综合征相关文献,详细分析了该类疾病的病因、少见症状、体征、解剖学特点及其机制。结果病人主诉声嘶、双下肢乏力 3h。入院诊断为延髓背外侧梗死、冠心病、心房颤动、心功能不全 2级、高血压病 2级(极高危)、 2型糖尿病、丙型肝炎。予以静脉溶栓、抗栓、调脂固斑、保护脑组织、扩容、补液、改善微循环等处理。出院时病人病情明显改善。本病例除具有经典 Wallenberg综合征临床表现外,还具有罕见的两侧面部及同侧下肢麻木,同侧面部周围性瘫痪,同侧舌下神经损伤等临床表现。结论 Wallenberg综合征病人临床特点及其解剖结构极其复杂,且相关机制有待进一步阐明。 |
英文摘要: |
Objective To share a rare case of Wallenberg syndrome variant (bilateral facial and ipsilateral lower extremities numb.ness) patient, so as to provide a reference for the clinical diagnosis of similar cases.Methods We retrospectively analyzed the etiolo.gy, clinical manifestations, auxiliary examinations, treatment methods along with therapeutic effects of a patient diagnosed with dorso.lateral medullary infarction admitted to People's Hospital of Fuyang on June 1st, 2019. The etiology, rare symptoms, physical signs, an.atomical characteristics and related mechanisms of this disease were analyzed in detail with reference to various literatures related toWallenberg syndrome.Results The patient complained of hoarseness and weakness of both legs for 3 hours. Admission diagnosis: dor.solateral medulla oblongata infarction, coronary heart disease, atrial fibrillation, cardiac insufficiency grade 2, hypertension grade 2(very high risk), type 2 diabetes, chronic bronchitis, hepatitis C, prostatic hyperplasia, intravenous thrombolysis. Antiplatelet aggrega.tion, anticoagulation, lipid regulation and plaque fixation, protection of brain cells, expansion, fluid supplementation, improvement ofmicrocirculation and other treatments were performed.The patient's condition was significantly improved upon discharge. In addition tothe classic clinical manifestations of Wallenberg syndrome, this patient also had rare clinical manifestations such as numbness on bothsides of the face and ipsilateral lower limb, ipsilateral peripheral paralysis, ipsilateral hypoglossal nerve injury.Conclusion The clini. cal characteristics and anatomic structure of the patients with Wallenberg syndrome are extremely complex, and the relevant mecha.nisms want to be further illuminated. |
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