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1、MillerFisher综合征和Bickerstaff脑干脑炎的临床特点及鉴别诊断【摘要】目的探讨MillerFisher综合征(MFS)和Bickerstaff脑干脑炎(BBE)的临床特点及鉴别诊断。方法回顾性分析12例MFS和15例BBE患者的临床资料。结果MFS组表现为视物成双12例，瞳孔対光反射消失3例，周围性面瘫7例，饮水呛咳1例，四肢无力6例，感觉障碍4例，共济失调10例；BBE组表现为视物成双11例，中枢性面瘫4例，耳鸣4例，饮水呛咳6例，四肢无力10例，感觉障碍2例，共济失调10例，嗜睡或昏迷5例，病理征9例。脑脊液检查MFS组和
2、BBE组各有10例表现为蛋白升高;MFS组脑脊液白细胞升高2例，BBE纽.6例。MFS纽.3例、BBE组1例肌电图出现神经源性损害。BBE纽•有6例CT或MRI检查异帘，主要部位为脑干、丘脑等。两纽•患者治疗后预后良好。结论MFS和BBE有相似特点，临床表现可以相互重魯，提示这两种疾病密切相关并形成一个连续的疾病谱；主耍鉴别点是BBE患者可以有意识障碍、病理征和影像学异常。【关键词】MillerFisher综合征；Bickerstaif脑I脑炎ClinicalfeaturesanddifferentialdiagnosisofMillerFish
3、ersyndromeandBickerstaifsbrainstemencephalitisWULei,WUWeiping,HUANGDehui,etal.DepartmentofNeurology,ChinesePLAGeneralHospital,Beijing100853,ChinaAbstract：ObjectiveTostudytheclinicalcharacteristicsanddifferentialdiagnosisofMillerFishersyndrome(MFS)andBickerstaffsbrainstemencep
4、halitis(BBE).MethodsTheclinicaldataof12patientswithdiagnosisofMFSand15patientswithdiagnosisofBBEwereanalyzedretrospectively.ResultsInMFSgroup,thepatientsshoweddiplopia(12cases),lossofpupillarylightreflex(3cases),peripheralfacialparalysis(7cases),hydroposiabucking(1case),weakn
5、essoflimbs(6cases),sensorydisability(4cases)andataxia(10cases)・InBBEgroup,thepatientspresentedwithdiplopia(11cases),centralfacialpalsy(4cases),tinnitus(4cases),hydroposiabucking(6cases),weaknessoflimbs(10cases),sensorydisability(2cases),ataxia(10cases),somnolenceorcoma(5cases
6、)andpositiveBabinskissign(9cases).CSFexaminationshowedelevationofproteinin10patientsfromBBEgroupand10patientsfromMSFgroup,however,leucocytosiswasfoundin6casesfromBBEgroupand2casesfromMSFgroup・Therewere4patientsofMFSand1patientofBBEwithabnormalresultsofelectromyogram(EMG)exami
7、nation.6patientsinBBEgrouphadabnormalresultsofCTorMRIexaminations,andthelesionsmainlylocatedinbrainstem,(halamusandsoon.Bothgroupshadgoodprognosisaftertherapies・ConclusionsMFSandBBEhavesimilarandoverlappedclinicalcharacteristics.Thisindicatesthatthesetwodiseasesarecloselyrela
8、tedandmayformacontinuousspectrum.ThemainidentificationsofBBEareconsc
