《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (09): 823-824.

• 专题 • 上一篇    下一篇

胆红素脑病引起不随意运动型脑性瘫痪35例临床分析

侯梅1;王海桥2   

  1. 1.青岛市妇女儿童医疗保健中心，青岛市儿童医院神经康复科，山东青岛市 266011;2.上海中医药大学附属岳阳中西医结合医院针灸科,上海市 200437
  • 收稿日期:2008-11-17 修回日期:2009-03-16 出版日期:2009-09-01 发布日期:2009-09-01

Dyskinetic Cerebral Palsy Associated with Bilirubin-encephalopathy: A Series Report

HOU Mei,WANG Hai-qiao   

  1. Department of Neurology & Rehabilitation, Qingdao Women and Children's Medical & Health Care Center, Qingdao Children's Hospital, Qingdao 266011, Shandong, China
  • Received:2008-11-17 Revised:2009-03-16 Published:2009-09-01 Online:2009-09-01

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被引次数

3

摘要： 目的 探讨胆红素脑病相关性脑瘫的临床及MRI特点。方法 对35例胆红素脑病导致的脑瘫病例进行回顾性分析。结果 27例于新生儿期后出现不明原因的过度哭闹、头后仰、角弓反张、身体扭转等早期神经症状表现，于呼吸道感染、腹泻等疾病状况后加重；突出的神经运动特点为非对称性紧张性颈反射、紧张性迷路反射和侧弯反射长时间残存，肌张力及姿势不稳定、不对称；粗大运动功能分级水平：Ⅰ级1例，Ⅱ级3例，Ⅲ级4例，Ⅳ级5例，Ⅴ级22例（其中15例年龄小于18个月）；29例行脑MRI检查，异常25例，其中22例为典型的双侧苍白球对称性长T2信号。结论 胆红素脑病引起不随意运动型脑瘫临床症状和脑MRI表现均有其特征。

关键词: 不随意运动, 脑性瘫痪, 胆红素脑病, 核黄疸, 磁共振成像（MRI）

Abstract: Objective To investigate the clinical features and magnetic resonance imaging (MRI) finding of cerebral palsy in children with bilirubin-encephalopathy. Methods 35 cerebral palsied children with a history of bilirubin-encephalopathy were retrospectively studied. Results 27 cases appeared some early symptoms of the nervous system, including excessive crying without any reason, hypsokinesis, body torquing, opisthotonos, which usually were aggravated by respiratory infection, fever, diarrhea, etc. The marked neuromotor characteristics included the instability and asymmetry of muscle tension and posture, the remaining of some primitive reflexs. According to the Gross Motor Function Classification, there was 1 case with I grade, 3 with II, 4 with III, 5 with IV, and 22 with V (of which 15 cases were younger than 18 months）. 29 cases accepted MRI, and 25 cases appeared abnormal, of which 22 showed typically high T2 signal in the bilateral globus pallidus. Conclusion The clinical and brain MRI findings of dyskinetic cerebral palsy associated with bilirubin-encephalopathy are characteristic and can be recognized easily.

Key words: dyskinesia, cerebral palsy, bilirubin-encephalopathy, kernicterus, magnetic resonance imaging (MRI)