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1例53岁上呼吸道感染男性患者为增加免疫力服用左旋咪唑50 mg,1次/d治疗,连续服药3 d。15 d后,患者出现头晕、嗜睡症状。之后,症状逐渐加重,出现动作迟缓、言语不清、行走困难、意识模糊及抽搐。1个月后患者陷入深度昏迷。动态脑电图检查示弥漫性δ波活动。核磁共振示双侧基底节区及额顶叶脑白质内见多发点状、斑片状长T2长T1信号灶,FLAIR序列和DW I呈高信号。诊断:左旋咪唑所致脱髓鞘脑病。给予糖皮质激素及对症治疗,1个月后患者好转,但仍有步态不稳。
One case of 53-year-old upper respiratory tract infection in male patients with levamisole 50 mg, 1 / d treatment for increasing immunity, continuous medication for 3 d. After 15 days, the patient developed dizziness and narcolepsy symptoms. Afterwards, the symptoms gradually aggravated with slowness of movement, unclear speech, difficulty walking, confusion and convulsions. One month later the patient fell into a deep coma. Dynamic EEG examination showed diffuse δ-wave activity. MRI showed bilateral multiple basal ganglia and parietal lobe white matter seen in multiple spots, patchy long T2 long T1 signal, FLAIR sequence and DWI showed high signal. Diagnosis: Levamisole induced demyelinating encephalopathy. Give glucocorticoids and symptomatic treatment, 1 month after the patient improved, but there are still unstable gait.