【關鍵詞】 脫髓鞘腦病
【摘要】 目的 報告2例食用麻辣火鍋後發生的.脫髓鞘腦病，並探討其可能發病機制。方法 記錄、分析2例患者的臨床表現，實驗室輔助檢查資料及治療經過。結果 2例患者均為急性發病，主要表現為中樞神經系統受累症狀、體徵；在大腦皮質下白質，顱腦核磁共振成像（MRI）T1和T2加權像顯示多發點、片狀異常訊號影，馬根維顯（Gd-DTPA）靜注T1顯示增強效應；皮質類固醇激素治療顯效；4年後隨診無復發。結論 食用麻辣火鍋後發生的脫髓鞘腦病可能與啟用自身免疫反應或某些物質對髓鞘的毒性作用有關。
【關鍵詞】 麻辣火鍋；脫髓鞘腦病
【Abstract】 Objective To report two patients with demyelinating encephalopathy after having peppery spicy chafing dish,and study the possible mechanism of ods Clinic manifestations,laboratory and assistant examination data,treatment of two cases were r neurologic diseases were lts Both were acute onset,systems and signs indicated that central nervous system were mainly showed multiple macula areas of abnormal signal intensity in T1 and T2-weighted images in white matter under subcotex,enhancing after gadolinium injected intravenously in the T1weighted patients recovered rapidly after treatment with e has been no relapse during the follow-up of 4 lusion Demyelinating encephalopathy duo to peppery spicy chafing dishes may be related with self-immunological response and some matter toxic to the myelin.
【Key words】 peppery spicy chafing dish;demyelinating autoimmune disease,CNS
在臨床工作中，脫髓鞘腦病並不少見，如自身免疫性和血管炎性疾病、工農業毒物和藥物不良反應等多種因素均可以引起［1］。但是，因食用麻辣火鍋引起的脫髓鞘腦病，目前國內外尚未見有文獻報道。現將我們收治的2例分析報告如下。
1 臨床資料
例1，患者，女，28歲，公司會計。患者主因視力急劇減退，伴頭痛1周入院。1周前，晚餐食用麻辣火鍋，當時即感全身熱灼不適，第2天晨起後，自覺視環境發暗如陰天，視物不清，頭脹痛，行走時左腿力弱。5天后因視物模糊、視力急劇下降，擬診球后視神經炎住本院眼科。顱腦MRI檢查，雙側額葉、顳葉、頂葉均見散在不規則T1低訊號，T2高訊號，注射增強劑，顯示不同程度強化，視交叉可見異常強化訊號（圖1a,b）。會診後轉住神經科。神經系統查體：雙眼眼前20cm處見指動，正常眼底，未見其他肯定陽性體徵。腦脊液壓力正常，常規無特殊。生化檢查：蛋白53mg/dl,IgG 32.5mg/dl（正常