多颅神经麻痹为首发表现的急性白血病一例

• 作 者: 夏章武
• 机 构: 江山县人民医院神经内科,
• 出 处: 浙江医学
• 发表日期: 1985年05期
• 关键词: 颅神经麻痹 颅神经受侵 多颅神经炎 急性白血病 颅内压增高 颅内高压症 骨髓检查 幼稚细胞 急性期 细胞学

脑膜或中枢神经系统白血病可在急性期的任何病期发生。在诊断成立后3个月内发病机会极少,常见的临床表现为颅内高压症,颅神经麻痹。以脑脊液的改变和细胞学的检查而确诊。颅神经麻痹以面神经多见,以多颅神经受侵犯为首发表现的报道不多。本例颅神经受侵犯的有Ⅴ、Ⅷ、Ⅸ、Ⅹ、Ⅻ,而无颅内压增高的表现及脑脊液的变化,曾误诊为多颅神经炎。一个月以后才出现血象的变化,并经骨髓检查而确诊早幼粒细胞性白血病(M_3型)。

Meningin or central nervous system leukemia can occur at any stage of the acute phase. Within 3 months after the diagnosis is established, the chances of onset are very few. The common clinical manifestations are intracranial hypertension and cranial nerve paralysis. Confirmed by changes in cerebrospinal fluid and cytology. Cranial nerve paralysis to the facial nerve more common to many cranial nerve invasion as the first performance of the report few. In this case cranial nerves were Ⅴ, Ⅷ, Ⅸ, Ⅹ, Ⅻ, without the performance of increased intracranial pressure and changes in cerebrospinal fluid, had been misdiagnosed as cranial neuritis. A month after the blood changes appeared, and confirmed by bone marrow examination of promyelocytic leukemia (M_3 type).