Text/Yangcheng Evening News all-media reporter Zhang Hua Correspondent Wei Xing
Photo/Courtesy of the hospital
Recently in Guangzhou, the cold of spring and the continuous spring rain added a lot of chill. Ms. Zhang, a 25-year-old who had just given birth to her second child, was transferred to the Department of Neurology of the First People's Hospital of Guangzhou City due to frequent vomiting for two weeks, accompanied by dizziness, instability and other symptoms, but she did not expect that after the transfer, she suddenly had cardiac arrest and cyanosis all over her body...
The sudden change overwhelmed the family, and the medical staff of the Intensive Care Unit (NCU) of the Department of Neurology of the First People's Hospital of Guangzhou were well trained, responded quickly to participate in the rescue, calmly and skillfully performed cardiopulmonary resuscitation, while emergency bronchoscopy transnasal endotracheal intubation and the establishment of rehydration channels, two minutes later, Ms. Zhang recovered her heartbeat and breathing, and regained consciousness on the same day. You know, cerebral ischemia for 6 minutes has the potential to cause irreversible brain damage.
Bulbar lesions, cerebral vascular normal
However, Ms. Zhang's magnetic resonance at the time of admission suggested a bulbar lesion. Although Ms. Zhang's life was saved, due to the medulla oblongata lesions, quadriplegia and respiratory muscle weakness caused by the bulbar lesions made it impossible to get out of the ventilator for a while.
What is it about a disease so dangerous?
Yu Jianmin, chief physician of the Department of Neurology of the First People's Hospital of Guangzhou, introduced that the day after Ms. Zhang transferred to NCU, she was diagnosed with a spectrum disease of optic nerve myelitis - posterior region syndrome. It turned out that in order to clearly diagnose the condition as soon as possible and be able to give effective treatment, medical staff stripped away the cocoon and quickly formulated a number of targeted measures.
First of all, a detailed medical history is collected for the patient, especially for the source of infection that may be exposed to, or repeated symptoms ignored by previous patients; at the same time, a detailed physical examination and EEG, CT, blood test, blood routine and other tests are performed, and the thyroid function is normal, but the thyroid function is abnormal, the liver function is abnormal, and the bilirubin is normal. Antinuclear antibodies (ANAs) 3.766, anti-SSA antibodies (+).
Patients undergo plasmapheresis therapy
Inflammatory? Immune? Metabolic? Tumoric? The differential diagnosis is glued. It is still not possible to exclude nervous system infections, neuroimmune diseases, and metabolic diseases. NCU doctors with rich clinical experience quickly completed lumbar puncture for patients, and the results of cerebrospinal fluid NGS were negative, and infectious diseases combined with EEG were basically excluded. Serum and cerebrospinal fluid antibodies suggest AQP4 (+). The final dawn appeared, and the diagnosis was confirmed the day after the transfer to the NCU, as a disease of the optic nerve myelitis lineage - posterior region syndrome.
It is understood that optic nerve myelitis spectrum disease (NMOSD) is a group of autoimmune-mediated inflammatory demyelinating diseases of the central nervous system with predominantly optic nerve and spinal cord involvement. In 2020, China released data based on the hospitalization registration system, and the incidence of NMOSD is about 0.278/(100,000 person-years), 0.075/(100,000 person-years) for children, and 0.347/(100,000 person-years) for adults. NMOSD is seen at all ages, mostly young adults, with an average age of onset of about 40 years; it is more common in women. Commonly used hormone shock, plasma exchange, human immunoglobulin shock, monoclonal antibody drugs and immunosuppressant sequential therapy.
Encourage patients to actively treat and help patients in respiratory rehabilitation treatment
After the diagnosis, Dr. Yu Jianmin's team first carried out targeted treatment for the patient: hormone shock therapy and plasmapheresis. During the treatment, Ms. Zhang was extremely depressed and even refused to cooperate with the treatment. The NCU medical staff patiently explained the patient's condition, careful nursing, and the neurology psychologist also intervened immediately to assist Ms. Zhang in fighting against the disease.
The patient recovered and was discharged from the hospital smoothly
The kung fu paid off, and the young mother, Ms. Zhang, was finally discharged from the hospital and returned to the warm family, and the two children also returned to the warm embrace of their mother. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Lin Qingqing