进行性空泡性脑白质病:一个谜

García Divahia, Martínez-Lizaga Natalia, Lanau Sara, Espinosa Eugenia
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引用次数: 0

摘要

从快速进行性恶化到长期临床稳定;在新生儿中,它会引起严重的神经系统和全身改变,包括癫痫发作、张力低下、生长迟缓、乳酸性酸中毒和呼吸衰竭。鉴于非特异性神经症状和神经影像学特征,与涉及中枢神经系统的感染或免疫状况的鉴别诊断是必不可少的,这是一项重要发现。摘要简介:进行性空化性白质脑病(PCL)是一种最近被描述的病理,在世界文献中报道的病例很少。它的特点是进行性神经退化和特征性的神经影像学发现,这区分了这种疾病作为一个独特的实体给予巨大的囊性变性。患者和方法:本文报告1例女性婴儿在27个月时出现运动技能和语言退化,随后在接下来的一年中出现进行性神经退化。结果:在颅MR检查中,观察到白质妥协和囊性变性,对比度增强,同时脑MR显示双阴性乳酸峰。脑白质营养不良的酶学研究,脑白质营养不良的遗传面板,和负线粒体外显子组。结论:由于本病呈进行性发展,符合临床诊断标准,符合PCL诊断标准。这个实体没有治疗;只有支持性护理可用。预后是致命的,在上述案例研究中,平均寿命可达14年。
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Progressive cavitational leukoencephalopathy: An enigma
from rapidly progressive deterioration to long periods of clinical stability; in newborns it causes severe neurological and systemic alterations, including seizures, hypotonia, growth retardation, lactic acidosis and respiratory failure [4]. Given the non-specific neurological symptoms and neuroimaging features, a differential diagnosis with infections or immunological conditions that involve the CNS is essential, an important finding Abstract Introduction: Progressive cavitational leukoencephalopathy (PCL) is a recently described pathology, with few cases reported in the world literature. It is characterized by progressive neurological deterioration and characteristic neuroimaging findings, which distinguish this disorder as a unique entity given the massive cystic degeneration . Patients and methods: A case of a female infant with regression of motor skills and speech is described at 27 months, followed by progressive neurological deterioration during the following year. Results: In cranial MR findings, white matter compromise and cystic degeneration with contrast enhancement were observed, along with a brain MRS with double negative lactate spikes. Enzymatic study of leukodystrophies, genetic panel for leukodystrophies, and negative mitochondrial exome. Conclusions: Due to the progressive form of the disease and paraclinical criteria, it is concluded that the patient meets the diagnostic criteria for PCL. This entity does not have treatment; only supportive care is available. The prognosis is fatal, with an average life of up to 14 years in the case studies described.
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