在没有并发症的阴道分娩后产后阴道神经病变
Nader Boutros1, Dina Saba2, Bhavesh Trikamji1
1Department of Neurology, University of California Riverside School of Medicine, Riverside, CA, USA.
The Neurohospitalist
|September 13, 2023
概括
产后坐骨神经病变 (PSN) 是罕见的,特别是在阴道分娩后. 本案例系列强调了阴道分娩后的两个PSN病例,强调了对这种潜在并发症的临床意识的必要性.
科学领域:
- 神经学 神经学
- 产科 产科 产科 产科 产科
- 神经系统疾病 神经系统疾病
背景情况:
- 产后神经病变相对比较常见,经常观察到股骨,骨和侧股骨皮肤神经病变.
- 在周产期期间的坐骨神经单元神经病变被认为是罕见的,之前的报告主要与剖腹产有关.
研究的目的:
- 在阴道分娩后报告一系列罕见的产后阴道神经病变 (PSN) 病例.
- 提高临床医生对非复杂的阴道分娩后PSN的可能性的认识.
主要方法:
- 介绍产后阴道分娩后发生的两种不同病例的产后阴道神经病变.
- 临床检查,包括对运动强度和感觉的神经学评估.
- 磁共振成像 (MRI) 排除脊髓,神经根或plexus参与.
- 电子诊断研究以确认坐骨髓单元神经病变并定位病变.
主要成果:
- 在正常的阴道分娩后,两名年轻女性在分娩后立即出现了脚.
- 神经学检查显示了坐骨神经功能障碍的特征迹象,包括脚下垂和感官缺陷.
- 核磁共振扫描排除了中枢神经系统或病变;电诊断研究证实了近端阴道单元神经病变.
- 两名患者在保守的管理下,在三个月内完全恢复了运动功能.
结论:
- 产后阴道神经病变可能发生在阴道分娩后,而不仅仅是剖腹产后.
- 这种情况虽然很少见,但应在产后下肢虚弱的差异诊断中考虑.
- 早期诊断和适当的管理,包括物理治疗,可以带来有利的结果.
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