Clinical analysis on 9 cases of nervous system disorder caused by Heat stroke / 中国神经精神疾病杂志

ABSTRACT

Objective To summarize the clinical characteristics , nerve electrophysiological features , imaging manifestations and prognosis of nervous system disorder caused by heat stroke. Methods A retrospective study was un?dertaken on clinical, nerve electrophysiological and imaging characteristics and prognosis of 9 patients who had heat Stroke and received treatment during July and August in 2010 and 2013 at the Second Hospital of Shandong University. Results There were seven males and two females, aged from 47 to 87 years, among 9 patients. All cases are admitted within 6 hours and their Core body temperature were 39.8℃~42.5℃. Patients had disturbance of consciousness and multi?ple organ dysfunction including acute cerebral infarct in 2 cases, peripheral neuropathy in 3 cases, acute respiratory fail?ure in 2 cases, pulmonary infection in 9 cases, disseminated intravascular coagulation in 1 case ,acute myocardial injury in 8 cases, arrhythmia in 3 cases, rhabdomyolysis in 3 cases, acute liver damage in 8 cases, of acute kidney injury in 6 cases, upper gastrointestinal bleeding in 4 cases, metabolic acidosis in 1 case, metabolic alkalosis in 2 cases , electrolyte disorder in 9 cases and quadriplegia in 3 cases. Brain magnetic resonance imaging showed diffuse brain swelling in 6 cas?es and the acute asymmetric lacunar infarction in 2 cases. All patients are treated with cooling , rehydration , anticoagula?tion , reduction of the intracranial pressure and symptomatic treatment. One case died and the condition of remaining cas?es were improved. At one-year follow-up, the symptoms were almost cured in 2 cases, significantly improved in 4 cases with disability degree in grade 1~2, moderately improved in 1 case with disability degree in grade 3, remained unchanged in 1 case with disability degree of grade 5. Conclusion Heat stroke can cause conscious disorder and multiple organ fail?ure .The central nervous system lesions are often presented with diffuse swelling or/and lacunar infarction and presented with peripheral nerve injury in some cases, leaving persistent neurological deficits .