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Objective:By analyzing the characteristics, diagnosis, and treatment process of anti-synthetase syndrome complicated by interstitial pneumonia and cardiac dysfunction, we aim to enhance general practitioners' understanding and diagnosis of this disease, thereby improving their level of diagnosis and treatment and reducing misdiagnoses and missed diagnoses.Methods:A patient with anti-synthase syndrome complicated by interstitial pneumonia and cardiac dysfunction, who was admitted to The First Affiliated Hospital of Xi'an Medical University in February 2020 due to limb weakness accompanied by paroxysmal cough for 2 years and aggravated symptoms for 10 days, was included in this study. The patient's clinical symptoms, physical signs, laboratory examination results, diagnosis and treatment process, and follow-up were retrospectively analyzed based on previous literature.Results:Through the general practitioner's SOAP consultation, physical examination, and imaging examination, the patient was diagnosed with anti-synthase syndrome complicated by interstitial pneumonia and cardiac dysfunction. Then rheumatology and immunology experts, respiratory medicine experts, and cardiovascular experts collaborated to provide a specialist diagnosis and treatment plan for the patient. Subsequently, the patient was referred to the department of rheumatology and immunology for specialized disease management. Finally, the patient was followed up in the general clinic. After the patient's condition stabilized, she gradually resumed her health.Conclusion:The multidisciplinary diagnosis and treatment scheme for anti-synthase syndrome can enhance general practitioners' understanding of the disease, make the diagnosis of the disease, and fully leverage the advantages of multi-disciplinary consultation and primary diagnosis in general medicine.
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Objective To investigate the value of magnetoencephalograph(MEG)combined neuronavigation in the operation of frontal and temporal epilepsy caused by focal cortical dysplasia(FCD). Methods The data of 44 cases of frontal and temporal epilepsy caused by FCD were analyzed retrospectively. The location of epileptogenic zone and assessment IQ ,memory and language of patients were tested before operation;MEG examination confirmed the language dominance hemisphere and clarified the scope of language function. The surgical navigation system was guided by the American medtronic steal health 7 surgical navigation system to protect the neurological function. IQ,memory and language examination were measured 1 year after operation,and the data were analyzed before and after operation. The patients were followed up for 13~ 44 months after operation,according to Engel′s classification standard,the curative effect of epilepsy was determined. Results MEG can accurately localize the location of the language functional areas and FCD Epileptogenic zone. Of the 44 language functional areas ,28 had the left hemisphere and 16 were on the right side. Statistics showed that the verbal IQ and total IQ increased(P<0.05)in 1 year after operation,and there was no significant change in memory quotient and operation IQ(P >0.05). FCD patients recovered well ,and no language and limb function damaged. The curative effect of epilepsy:18 cases of Engel′sⅠgrade,22 cases of Engel′sⅡgrade;4 cases of Engel′sⅢgrade. Conclusions MEG combined with neuronavigation plays an important role in the localization ,localization and guidance of epileptogenic zone in patients with refractory frontal and temporal epilepsy caused by FCD ,which can protect the cortex function,avoid serious postoperative complications,and improve the therapeutic effect of epilepsy.
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Objective To summary the electroencephalography characteristics of temporal lobe ganglion glioma (GG),and explore the role of electroencephalogram in diagnosis and treatment of temporal lobe GG.Methods Retrospective analysis of clinical features,diagnosis and treatment of 24 patients with temporal lobe GG,admitted to our hospital from September 2008 to September 2015,was performed.The temporal lobe GG electroencephalography features were accepted focused research.Results Break electroencephalography showed that:abnormal discharge of lesions in store area and contralateral brain regions was noted in 17 patients (70.8％).Episodes electroencephalography showed that:10 patients (41.6％) could be conformed that discharge was originated from the side of temporal sphenoid.Intra-operative electroencephalography showed that the medial temporal lobe in 22 patients (91.7％) had low amplitude fast wave with high reflection of sharp wave or spike wave;the temporal lobe cortex in 23 patients (95.8％) had high reflection of sharp wave or spike wave.The patients were followed up for one to 8 years.Engel's grading I was noted in 19 patients (79％),including 11 gradually stopped taking antiepileptic drugs after three years of free seizure;Engel's grading Ⅱ was noted in 5 patie nts (79％),and antiepileptic drugs were taken.Conclusions The temporal lobe GG electroencephalography shows that abnormal discharge is sharp and slow waves are noted,which are easy to generalize to other brain regions and the contralateral side.Monitoring of electroencephalography during operation can record the abnormal discharge around and in the center of GG with spike wave rhythms.Cortical electroencephalogram and deep electrode monitoring can help to determine the lesion and the around range of epilepsy,which can guide the operation and improve the control of seizures.
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ObjectiveTo explore the clinic symptom and the characteristics of video,tightly close,intracranial electroencephalogram (EEG) of patients with central region diastematia epilepsy. Methods Retrospective analysis of 9 patients with central region diastematia epilepsy admitted from June,2007 to August,2009.The characteristics of all patients' seizure symptom and EEG manifestation were analyzed using patients' medical history,video and EEG records.ResultsPatients with central region diastematia epilepsy had relatively long sezure history.The duration of seizure was commonly short,with frequent episode and no obvious intelligence impairment.The seizure was often accompanied with the hyperkinesia in the lower limbs.Scalp EEG showed discharges with low amplitude waves in the mean line area.The superhigh amplitude and regular rhythm slow sharp wave could be found in the diastematia cortex EEG.All patients had an Engel Class Ⅰ outcome after surgery.ConclusionThe seizure symptoms are characteristic in the patients with central region diastematia epilepsy,and some special manifestations can be found in different phase,wave amplitude,rhythm,lead array.