病毒性脑炎所致阵发性自主神经性不稳伴肌张力不全1例
Paroxysmal Autonomic Instability with Dystonia Induced by Viral Encephalitis: A Case Report
摘要: 目的：探讨病毒性脑炎所致阵发性自主神经性不稳伴肌张力不全(PAID)的临床特点及治疗对策。方法：回顾性分析本院收治的1例病毒性脑炎所致PAID的临床资料。结果：患儿出现阵发性躁动、发热、多汗、呼吸急促、心动过速、血压升高、肌张力障碍和抽搐症状，经联合用药治疗后，患儿逐步好转出院，随访1年半，四肢肌张力恢复正常，未遗留下严重后遗症状。结论：由病毒性脑炎所致的PAID较少见，应注意早期识别，积极控制PAID症状，宜尽早联合两种或两种以上药物治疗。
Abstract: Objective: To explore the clinical features and therapeutic strategy of Paroxysmal autonomic instability with dystonia (PAID) induced by viral encephalitis. Methods:The clinical data of one child with PAID induced by viral encephalitis diagnosed in our hospital was analyzed retrospectively. Results: The child presented with intermittent agitation, fever,diaphoresis, tachycardia,tachypnea, hypertension, extensor posturing and seizures.Through the treatment of combined drugs, the child was gradually improved and discharged.After a follow-up of one and a half years, themuscular tension of limbs returned to normal and there were not serious neurologic sequelae. Conclusion: The PAID induced by viral encephalitis is rare. Early recognition is of paramount importance to start treatment in an early stage and various drugs should be combined to alleviate PAID.
文章引用：易招师, 查剑, 钟建民, 吴华平, 虞雄鹰, 陈勇. 病毒性脑炎所致阵发性自主神经性不稳伴肌张力不全1例[J]. 亚洲儿科病例研究, 2013, 1(3): 41-44. http://dx.doi.org/10.12677/ACRP.2013.13010

参考文献

[1] J. A. Blackman, P. D. Patrick, M. L. Buck, et al. Paroxysmal autonomic instability with dystonia after brain injury. Archives of Neurology, 2004, 61(3): 321-328.
[2] I. J. Baguley, I. D. Cameron, A. M. Green, et al. Pharmacologi- cal management of dysautonomia following traumatic brain in- jury. Brain Injury, 2004, 18(5): 409-417.
[3] 谢秋幼, 李洵桦, 虞容豪等. 脑损伤后发作性自主神经功能障碍的临床特点[J]. 临床神经病学杂志, 2009, 22(3): 184- 186.
[4] N. A. Ramdhani, M. A. Sikma, T. D. Witkamp, et al. Paroxysmal autonomic instability with dystonia in a patient with tuberculous meningitis: A case report. Journal of Medical Case Reports, 2010, 4: 304.
[5] J. Gil Antón, J. López Bayón, Y. López Fernández, et al. Auto- nomic dysfunction syndrome secondary to tuberculous meningi- tis. Anales de Pediatria, 2004, 61(5): 449-450.
[6] L. Safadieh, R. Sharara-Chami and O. Dabbagh. Paroxysmal autonomic instability with dystonia after pneu-mococcal meningoencephalitis. Case Reports in Medicine, 2012, 2012: 965932.
[7] A. A. Rabinstein. Paroxysmal autonomic instability after brain injury. Archives of Neurology, 2004, 61(10): 1625.
[8] R. P. Goddeau Jr., S. B. Silverman and J. R. Sims. Dexmedetomidine for the treatment of paroxysmal autonomic instability with dystonia. Neurocritical Care, 2007, 7(3): 217-220.
[9] 刘斌, 王勇, 骆健明等. 高血压脑出血后发作性自主神经功能不稳伴肌张力障碍[J]. 中华临床医师杂志, 2012, 6(2): 298- 301.
[10] I. Perkes, I. J. Baguley, M. T. Nott, et al. A review of paroxysmal sympathetic hyperactivity after acquired brain injury. Archives of Neurology, 2010, 68: 126-135.
[11] N. Lubarr, S. Bressman. Treatment of generalized dystonia. Current Treatment Options in Neurology, 2011, 13(3): 274-289.
[12] D. M. Lemke. Sympathetic storming after severe traumatic brain injury. Critical Care Nurse, 2007, 27(1): 30-37.
[13] J. F. Fernández-Ortega, M. A. Prieto-Palomino, A. Muñoz-López, et al. Prognostic influence and computed tomography findings in dysautonomic crises after traumatic brain injury. Journal of Trauma, 2006, 61(5): 1129-1133.