Delayed encephalopathy after strangling.
Delayed encephalopathy after strangling.
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DOI：
10.1001/archneur.1976.00500030052011
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发表时间：
1976-03
影响因子：
--
通讯作者：
E. Dooling;E. Richardson
中科院分区：
文献类型：
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作者：
E. Dooling;E. Richardson
一名 11 岁男孩曾被勒死，一周内没有任何症状，随后出现躯干和四肢不自主运动，以及反复发作的角弓反张和自主神经功能障碍。与此同时，他仍然保持警惕，精神状态似乎完好无损。脑电图正常。他在神经系统疾病发作 13 周后去世。神经病理学检查显示双侧尾状核、壳核和苍白球有空洞性病变，但白质不受影响。在各种形式的缺氧缺血性损伤中，包括先前报道的勒死病例，已注意到逐渐发展的神经系统疾病的延迟发作，但无法从之前的临床状态或病程预测其发生。在异常运动占主导地位的病例中，尽管前述情况存在差异，但病理结果相似。我们建议这些病例常见的潜在代谢紊乱可能是乳酸性酸中毒，并且应对它们进行研究以寻找生化缺陷的证据。
An 11-year-old boy who had been the victim of a strangling attempt was asymptomatic for one week whereupon involuntary movements involving the trunk and limbs developed, along with repetitive episodes of opisthotonos and autonomic dysfunction. Meanwhile, he remained alert and appeared to be mentally intact. An electroencephalogram was normal. He died 13 weeks after the onset of the neurological disorder. The neuropathological examination showed cavitating lesions in the caudate nucleus, putamen, and globus pallidus bilaterally, with sparing of the white matter. The delayed onset of a progressively evolving neurological disorder has been noted in various forms of hypoxicischemic insult, including previously reported cases of strangling, but its occurrence cannot be predicted from the preceding clinical state or course. In the cases in which abnormal movements have been predominant, the pathological findings have been similar despite diversity in the preceding circumstances. We suggest the underlying metabolic disorder common to these cases may be lactic acidosis, and that they should be studied for evidence of a biochemical defect.