Vol. 17, No. 2, November, 2009 □ 증 례 □
- 253 -
1)
서 론
(midbrain), (pons), (medulla oblongata)
(spinal cord) .
(mesence-
phalitis) (rhom-
bencephalitis)
1)
.
,
7 7
1 .
증 례
: 2009 8 19 , : 2009 10 16
: ,
Tel : 02)2228-2063, Fax : 02)393-3080 E-mail : [email protected]
환 아 : ○○ , , 7 7
주 소 : ,
출생력 : 3.0 kg .
가족력 : 2 , ,
. 과거력 :
현병력 : 5 ,
, .
.
진찰 소견 : 37.3 , ℃
90 / , 20 / , 105/60 mmHg
.
, ,
.
. .
두통과 복시를 주소로 내원한 뇌간 뇌염 1례
권혜은 박은정 이윤진 이준수․ ․ ․
= Abstract =
A Case of Brainstem Encephalitis Presented with Diplopia and Headache
Hye Eun Kwon, M.D., Eun Jung Park, M.D.
Yun Jin Lee, M.D. and Joon Soo Lee, M.D., Ph.D.
Department of Pediatrics, Pediatric Epilepsy Clinics, Severance Childrens Hospital Brain Reserch Institute, Yonsei University College of Medicine, Seoul, Korea
Brainstem encephalitis is a rare disease and patients typically present with symptoms of areflexia, ataxia, and ophthalmoplegia. We experienced a case of brainstem encephalitis in a 7 years old girl, who presented with diplopia and headache. It can be reliably confirmed by magnetic resonance imaging(MRI) and CSF analysis. We report a case of brainstem encephalitis in a child, with a brief review of literature.
Key Words : Brainstem encephalitis, Diplopia, Headache
― 3 : 1 ―
- 254 - .
. .
. ,
.
.
검사 소견 : 6,460/
mm
3, 13.3 g/dL, 37.4%,
280,000/mm
3. .
90/µL 99% ,
0/µL, 25 mg/dL, 75 mg/dL , .
. 1:320 3
.
방사선학적 소견 :
. T2
(left rectus gyrus), ,
(Fig. 1A, 1B).
뇌파 검사 :
. 치료 및 경과 :
,
.
,
(vancomycin 60 mg/kg/day, ceftriaxone 100 mg/kg/day)
(acyclovir 30 mg/kg/day)
. 2, 3 1 g/kg
2 . 3
6
. 14
(Fig. 2A, 2B).
.
.
Fig. 1A. Axial T2-weighted brain MRI showed increased signal intensity with edema in pons.
Fig. 1B. Axial T2-weighted brain MRI showed increased signal intensity with edema in left rec- tus gyrus and midbrain.
― : 17 2 2009 ―
- 255 -
고 찰
(mesen-
cephalitis) (rhom-
bencephalitis) 1951 Bickerstaff Cloak
2)
. (areflexia), (ataxia), (ophthalomoplegia)
, , .
.
1, 3, 4)
, Listeria monocytogenes
3, 5, 6)
. Myco -
plasma pneumoniae , influenza A, adenovirus, enterovirus 71, rubella, Epstein-Barr virus
7-12)
.
.
1-6, 11)
,
, ,
6)
.
. 1:
320
.
2, 13, 14)
.
11, 14)
15)
.
15)
.
.
T2 (midbrain), (pons),
(medulla)
1, 11). T2
, , , ,
, , ,
,
15)
.
,
1, 3-6)Fig. 2A. Two weeks later, follow up brain MRI did not show the increased signal intensity or parenchymal swelling in T2 weighted image com- pared to previous images.
Fig. 2B. Two weeks later, follow up brain MRI did not show the increased signal intensity or parenchymal swelling in T2 weighted image com- pared to previous images.
― 3 : 1 ―
- 256 -
16)
. Enterovirus
,
16)
.
L. monocytogenes
17)
. M. pneumoniae
7)
.
.
요 약
, 7
7
1 .
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