以精神障碍首发的病毒性脑膜脑炎临床分析

[摘要] 目的 分析以精神障碍为首发症状的病毒性脑膜脑炎的临床特点。 方法 回顾3年来收治的以精神障碍为首发症状的病毒性脑膜脑炎病例8例，同时以典型症状首发的病例8例为对照，分析对比其首发症状、诊断过程及治疗效果等特点。 结果 实验组8例病例，平均年龄7.8岁，首发症状3 例表现为躁狂症状，3 例表现为抑郁症状；2 例表现为癔症发作。确诊时间平均为3.2 d，较对照组延长，头颅CT异常率较对照组显著高，脑电图、生化结果无明显差异，脑脊液异常率较对照组增高，平均住院时间为（16.0±1.85）d，较对照组延长。结论 单纯以精神障碍为首发症状的病毒性脑膜脑炎病例在临床上少见，学龄前期及学龄期儿童无明显诱因出现精神障碍时需排除病毒性脑膜脑炎的可能。

[关键词] 病毒性脑膜脑炎；精神障碍；首发症状

[中图分类号] R512.3 [文献标识码] B [文章编号] 1673—9701（2012）25—0145—02

Viral meningoencephalitis started with spiritual obstacle： A clinical analysis of 8 cases

XU Shifang1 WANG Airong1 LI Huabing1 YANG Zengjin2 YU Haibin3

1.Department of Pediatrics， Zhucheng People's Hospital in Shandong Province， Zhucheng 262200， China； 2. Department of Maternity， Zhucheng Maternity and Child Care Centers in Shandong Province， Zhucheng 262200， China； 3.Department of Ophthalmology， Zhucheng Changcheng Health Hospital in Shandong Province， Zhucheng 262200l， China

[Abstract] Objective To explore clinical characteristics of the mental disorder as initial symptoms of viral meningoencephalitis. Methods A review 8 patients with mental disorder as the first symptom of viral encephalitis cases A retrospective analysis of 3 years was maken， in it 8 cases of viral meningoencephalitis started with psychiatric disorders were studide， at the same time 8 cases with the typical symptoms as controls， compared their starting symptoms， diagnosis and treatment process， etc. Results The average age of 8 cases was 7.8 years， 3 cases starting for bipolar disorder symptoms， 3 cases of symptoms start for depression， and 2 cases symptoms start for hysteria attacks.Average diagnose time was 3.2 days， extended than the control group， Head CT abnormal rate was significantly higher than that of control group ，two groups of EEG， biochemical results had no obvious difference， CSF abnormalities rate higher than that of the control group， the mean hospital stay was （16.0±1.85） days， extended than the control group. Conclusion Viral meningoencephalitis started with mental disorder symptoms simply in clinical is a rare， If the school age or school—aged appear mental disorders by no significant incentives ， have to rule out the possibility of viral meningoencephalitis.

[Key words] Viral meningoencephalitis； Mental disorders； First symptoms

病毒性脑膜脑炎是由病毒感染引起的脑膜和脑实质弥漫性炎性综合征，是儿科常见的中枢神经系统感染性疾病。年长儿多以发热、头痛、头晕、呕吐为首发症状，婴幼儿发病则多以发热、抽搐及意识障碍多见。单纯以精神障碍首发的病例少见，不容易被发现。现将2008年6月～2011年6月我院收治的8例单纯以精神症状首发的病毒性脑膜脑炎病例总结如下。

1资料与方法