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本文报告3例嗜酸细胞脑膜炎合并顽固性肢体疼痛的病人。例1,女,44岁。在斐济食蜗牛、对虾后3天,头痛、乏力、恶心、厌食、腹痛、持续下肢肌痛,一过性意识模糊。检查:左视盘水肿,双眼外展麻痹,左侧周围性面瘫,颈抵抗,右上肢无力且腱反射减弱。CSF压力>30cmH_2O,蛋白7g/L,糖1.8mm/L,白细胞50g/mm~3,淋巴82%,酸性18%,浆细胞4%,碱性1%,符合嗜酸性细胞脑膜炎广州圆线虫(Angiostirongylus Cantonensis)。血清抗体(ELISA法)阳性。EEG颞区慢波活动及左颞少许尖波,EMG右上肢纤颤、幕集(recruitment),减低。示有失神经的证据。左尺神经SEP示Erb’s点(N9)、颈—延髓(N13)和丘脑皮层(N/p19)电位缺失,右侧Erb’s点电位亦缺失。头颅CT(-),MRI示两半球、小脑多发散在,白质病灶。20个月时仍留躯体和下
This article reports 3 patients with eosinophilic meningitis with refractory limb pain. Example 1, female, 44 years old. In Fiji food snails, shrimp after 3 days, headache, fatigue, nausea, anorexia, abdominal pain, persistent lower extremity myalgia, transient unconsciousness. Check: left optic disc edema, paralysis of both eyes outreach, left facial paralysis, neck resistance, weakness of the right upper limb and tendon reflexes. CSF pressure> 30cmH2O, protein 7g / L, sugar 1.8mm / L, white blood cells 50g / mm ~ 3, lymphatic 82%, acidic 18%, plasma cells 4%, alkaline 1%, in line with eosinophilic meningitis (Angiostirongylus Cantonensis). Serum antibody (ELISA method) positive. EEG temporo-temporal slow wave activity and a small spike in the left temporal lobe, EMG right upper limb fibrillation, the screen recruitment (recruitment), reduced. Show evidence of denervation. SEP of left ulnar nerve showed Erb’s point (N9), neck-medulla oblongata (N13) and thalamocortical (N / p19) potentials were deleted, and right Erb’s point potential was also deleted. Head CT (-), MRI showed two hemispheres, cerebellum and more scattered in white matter lesions. Body and lower body remain at 20 months