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神经梅毒的诊断治疗现状教学课件.ppt

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文档介绍:Current situation of Neurosyphilis: Diagnosis and Treatment 神经梅毒的诊断治疗现状


Neurosyphilis: Diagnosis and Treatment 神经梅nfection(called late asymptomatic syphilis);
梅毒螺旋体感染后脑脊液持续5年出现异常,可定义为晚期无症状神经梅毒;
The development of neurologic disease in up to 87%of patients.
该类晚期无症状神经梅毒中大约有87%可能发展为有症状神经梅毒。
Symptomatic症状型神经梅毒
Acute syphilitic meningitis
急性梅毒性脑膜炎
Meningovascular syphilis:
脑膜血管性梅毒
Cerebrovascular syphilis;
大脑膜血管性梅毒
Meningovascular syphilis of the spinal cord.
脊髓膜血管性梅毒。
Symptomatic症状型神经梅毒
Acute syphilitic meningitis:
急性梅毒性脑膜炎
The incubation period in the majority of patients with syphilis meningitis is less than 1 years;
大部分梅毒性脑膜炎患者的潜伏期在一年之内;
25% of those patients meningitis is the first clinical manifestation of syphilis;
大约有25%的梅毒性脑膜炎患者是以梅毒的首发症状出现的;
A small percentage of patients(15%) still have a 2nd rash at the time of the meningitis.
大约15%的患者在出现梅毒性脑膜炎的同时,仍然具有二期梅毒的皮肤损害。
Acute syphilitic meningitis 急性梅毒性脑膜炎
Clinical manifestitations:
临床表现
Cranial nerve palsies (sense) in 40% of cases;
大约40%的患者有颅神经麻痹(感觉障碍)
The signs of increased intracranial pressure;
部分患者可有颅内压增高的表现
The involvement of cranial nerves(3rd, 6th,7th, 8th);
多数可以累及3、6、7、8对颅神经
Sensorineural deafness may occur in about 20% of patients.
大约20%的患者可以出现感音神经性耳聋。
Acute syphilitic meningitis 急性梅毒性脑膜炎
Clinical manifestitations:临床表现
Acute syphilitic hydrocephalus was seen in 1/3 of the cases of meningitis;
大约1/3的梅毒性脑膜炎患者可出现梅毒性脑水肿;
The principal symptoms and signs are those of increased intracranial pressure (stiff neck, confusion, delirium, papilledema);
主要症状与体征是因为颅内压增高而引起的(颈部僵硬,意识丧失,谵妄等);
Syphilitic meningitis with cerebral changes accounts for ¼ of early neurosyphilis;
在早期神经性梅毒患者中大约有1/4具有梅毒性脑膜炎伴发大脑的改变
Fever is only low grade or may be absent
可有低度发热或无发热
Acute syphilitic meningitis 急性梅毒性脑膜炎
Laboratory fingings;实验室检查
The blood Wassermann reaction was +ve in 64%;
大约64%的患者血清华氏曼反应阳性;
RPR is +ve in most of cases of ASM;
大部分血清非螺旋体实验阳性
The CSF include:脑脊液异常表现包括:
elevated pres

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神经梅毒的诊断治疗现状教学课件.ppt

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