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Neurology：NCSE引起的Balint综合征

2018-09-15 杨中华 脑血管病及重症文献导读

NCSEBalint综合征共济失调
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54岁，女性。因视觉障碍几天到急诊室就诊。

54岁，女性。

因视觉障碍几天到急诊室就诊。

查体发现动眼运用不能，图片中动作失认和视觉性共济失调，诊断为Balint综合征，也称为双顶综合征。

头MRI显示双侧顶枕叶T2 Flair高信号，大部分局限于皮层的灰质，相同区域可见DWI高信号：



视频脑电图和临床表现提示该患者为非痉挛性癫痫持续状态（NCSE）。

最终作者认为NCSE引起Balint综合征。

原始出处：Rossi KC, Brandstadter R, Fields MC, et al. Clinical Reasoning: A 54-year-old woman with confusion and visual disturbances. Neurology. 2018 Aug 21;91(8):363-367. 

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2000583, encodeId=7bac2000583b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Oct 21 08:17:00 CST 2018, time=2018-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946238, encodeId=6dec1946238f2, content=<a href='/topic/show?id=79051259616' target=_blank style='color:#2F92EE;'>#NCSE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12596, encryptionId=79051259616, topicName=NCSE)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK17mLkWpia3T92NlEWTkEhrhZa7XPNic2JqQumEicZXGYFG6Ww5SCIl0Uq62bhhPnibAqIZDHtRva92A/132, createdBy=e0752500025, createdName=江川靖瑶, createdTime=Mon Nov 19 23:17:00 CST 2018, time=2018-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1649565, encodeId=b5871649565cb, content=<a href='/topic/show?id=0c18533558' target=_blank style='color:#2F92EE;'>#CSE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5335, encryptionId=0c18533558, topicName=CSE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=825923859681, createdName=sjzlzc015, createdTime=Thu Aug 01 04:17:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431325, encodeId=ed0e1431325d7, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 17 03:17:00 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345122, encodeId=6a7a345122a9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Sep 15 16:40:27 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345098, encodeId=5f1a345098d9, content=好文，值得点赞！认真学习，应用于实践！谢谢分享给广大同好！, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eb131638261, createdName=lietome24, createdTime=Sat Sep 15 12:37:38 CST 2018, time=2018-09-15, status=1, ipAttribution=)]
    2018-10-21 yinhl1978

    #Neurol#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2000583, encodeId=7bac2000583b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Oct 21 08:17:00 CST 2018, time=2018-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946238, encodeId=6dec1946238f2, content=<a href='/topic/show?id=79051259616' target=_blank style='color:#2F92EE;'>#NCSE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12596, encryptionId=79051259616, topicName=NCSE)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK17mLkWpia3T92NlEWTkEhrhZa7XPNic2JqQumEicZXGYFG6Ww5SCIl0Uq62bhhPnibAqIZDHtRva92A/132, createdBy=e0752500025, createdName=江川靖瑶, createdTime=Mon Nov 19 23:17:00 CST 2018, time=2018-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1649565, encodeId=b5871649565cb, content=<a href='/topic/show?id=0c18533558' target=_blank style='color:#2F92EE;'>#CSE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5335, encryptionId=0c18533558, topicName=CSE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=825923859681, createdName=sjzlzc015, createdTime=Thu Aug 01 04:17:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431325, encodeId=ed0e1431325d7, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 17 03:17:00 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345122, encodeId=6a7a345122a9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Sep 15 16:40:27 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345098, encodeId=5f1a345098d9, content=好文，值得点赞！认真学习，应用于实践！谢谢分享给广大同好！, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eb131638261, createdName=lietome24, createdTime=Sat Sep 15 12:37:38 CST 2018, time=2018-09-15, status=1, ipAttribution=)]
    2018-11-19 江川靖瑶

    #NCSE#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2000583, encodeId=7bac2000583b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Oct 21 08:17:00 CST 2018, time=2018-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946238, encodeId=6dec1946238f2, content=<a href='/topic/show?id=79051259616' target=_blank style='color:#2F92EE;'>#NCSE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12596, encryptionId=79051259616, topicName=NCSE)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK17mLkWpia3T92NlEWTkEhrhZa7XPNic2JqQumEicZXGYFG6Ww5SCIl0Uq62bhhPnibAqIZDHtRva92A/132, createdBy=e0752500025, createdName=江川靖瑶, createdTime=Mon Nov 19 23:17:00 CST 2018, time=2018-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1649565, encodeId=b5871649565cb, content=<a href='/topic/show?id=0c18533558' target=_blank style='color:#2F92EE;'>#CSE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5335, encryptionId=0c18533558, topicName=CSE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=825923859681, createdName=sjzlzc015, createdTime=Thu Aug 01 04:17:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431325, encodeId=ed0e1431325d7, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 17 03:17:00 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345122, encodeId=6a7a345122a9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Sep 15 16:40:27 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345098, encodeId=5f1a345098d9, content=好文，值得点赞！认真学习，应用于实践！谢谢分享给广大同好！, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eb131638261, createdName=lietome24, createdTime=Sat Sep 15 12:37:38 CST 2018, time=2018-09-15, status=1, ipAttribution=)]
    2019-08-01 sjzlzc015

    #CSE#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2000583, encodeId=7bac2000583b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Oct 21 08:17:00 CST 2018, time=2018-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946238, encodeId=6dec1946238f2, content=<a href='/topic/show?id=79051259616' target=_blank style='color:#2F92EE;'>#NCSE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12596, encryptionId=79051259616, topicName=NCSE)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK17mLkWpia3T92NlEWTkEhrhZa7XPNic2JqQumEicZXGYFG6Ww5SCIl0Uq62bhhPnibAqIZDHtRva92A/132, createdBy=e0752500025, createdName=江川靖瑶, createdTime=Mon Nov 19 23:17:00 CST 2018, time=2018-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1649565, encodeId=b5871649565cb, content=<a href='/topic/show?id=0c18533558' target=_blank style='color:#2F92EE;'>#CSE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5335, encryptionId=0c18533558, topicName=CSE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=825923859681, createdName=sjzlzc015, createdTime=Thu Aug 01 04:17:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431325, encodeId=ed0e1431325d7, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 17 03:17:00 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345122, encodeId=6a7a345122a9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Sep 15 16:40:27 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345098, encodeId=5f1a345098d9, content=好文，值得点赞！认真学习，应用于实践！谢谢分享给广大同好！, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eb131638261, createdName=lietome24, createdTime=Sat Sep 15 12:37:38 CST 2018, time=2018-09-15, status=1, ipAttribution=)]
    2018-09-17 zhouqu_8

    #综合征#

    0

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    2018-09-15 医者仁心5538

    学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2000583, encodeId=7bac2000583b3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Oct 21 08:17:00 CST 2018, time=2018-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946238, encodeId=6dec1946238f2, content=<a href='/topic/show?id=79051259616' target=_blank style='color:#2F92EE;'>#NCSE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12596, encryptionId=79051259616, topicName=NCSE)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK17mLkWpia3T92NlEWTkEhrhZa7XPNic2JqQumEicZXGYFG6Ww5SCIl0Uq62bhhPnibAqIZDHtRva92A/132, createdBy=e0752500025, createdName=江川靖瑶, createdTime=Mon Nov 19 23:17:00 CST 2018, time=2018-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1649565, encodeId=b5871649565cb, content=<a href='/topic/show?id=0c18533558' target=_blank style='color:#2F92EE;'>#CSE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5335, encryptionId=0c18533558, topicName=CSE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=825923859681, createdName=sjzlzc015, createdTime=Thu Aug 01 04:17:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431325, encodeId=ed0e1431325d7, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 17 03:17:00 CST 2018, time=2018-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345122, encodeId=6a7a345122a9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Sep 15 16:40:27 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345098, encodeId=5f1a345098d9, content=好文，值得点赞！认真学习，应用于实践！谢谢分享给广大同好！, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eb131638261, createdName=lietome24, createdTime=Sat Sep 15 12:37:38 CST 2018, time=2018-09-15, status=1, ipAttribution=)]
    2018-09-15 lietome24

    好文，值得点赞！认真学习，应用于实践！谢谢分享给广大同好！

    0

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