神经沙丘病症:一个诊断挑战
Kiruba Shankar Manoharan1, Agalya Pauline Vasanthi Leoni1, Deepa Mary Samuel1
1Deptartment of ENT, Skull Base, Head and Neck Surgery, Apollo Main Hospitals, Chennai, 600006 Tamilnadu India.
概括
模仿其他疾病的神经类瘤发作是一个诊断挑战. 活检证实非化粒瘤,导致诊断和成功的类固醇治疗神经干扰.
科学领域:
- 神经学 神经学
- 病理学 病理学 病理学
背景情况:
- 单独神经受影响的神经沙症带来了诊断挑战,模仿感染,血管炎,IgG4疾病和恶性瘤等疾病.
- 早期诊断和治疗对于管理神经类症和预防长期神经学缺陷至关重要.
研究的目的:
- 为了突出神经类病的诊断挑战呈现与孤立的头骨神经参与.
- 提出一个案例报告,说明神经类病的诊断途径和成功管理.
主要方法:
- 一个59岁的女性的案例研究,她有面部疼痛,头痛和双眼视的症状.
- 临床检查显示第五和第六头骨神经受损.
- 诊断成像包括MRI和PET-CT.
- 神经活检的组织病理学检查证实了非病变性颗粒瘤.
主要成果:
- 核磁共振扫描显示,增强的软组织病变在pterygopalatine fossa和pterygomaxillary裂,延伸沿V2和V3.
- PET-CT 显示左下神经沿线存在高代谢性损伤.
- 血管炎小组没有得出结论.
- 活检证实了非致病性颗粒瘤,确立了神经类症的诊断.
结论:
- 在神经类症中,孤立的头骨神经参与是一个诊断挑战,需要高度的怀疑指数.
- 除了感染和恶性瘤之外,非致病性颗粒瘤的组织病理学确认是诊断的关键.
- 类固醇治疗可以导致神经类固醇症的显著临床和症状改善.
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