自體免疫性腦炎及腦脊髓炎導致截癱（Paraplegia）之中醫治療病例報告

TCM Treatment of Paraplegia caused by Autoimmune Encephalitis and Encephalomyelitis: A Case Report

10.6528/CAMS.202401_11(1).0002

王國峰(Wang, Kuo-Feng)；楊依玲(Yang Yi-Ling)；湯其暾(Tang, Chi-Tun)；李政育(Lee, Chen-Yu)

自體免疫性腦炎 ； 腦脊髓炎 ； 截癱 ； 中醫藥治療截癱 ； Autoimmune encephalitis ； Encephalomyelitis ； Paraplegia ； TCM treatment of paraplegia

中國鍼灸學雜誌

11卷1期（2024 / 01 / 07）

35 - 51

繁體中文;英文

自體免疫性腦炎是發生率不高的罕見重症，十萬人中有13.7人罹患此病。本案例為27歲男性，其臨床表現初期為發燒、頭痛、視覺不適等症狀，持續發燒、症狀無緩解，發病5日後由急診轉住院治療。再經5日出現意識混亂及持續癲癇發作等症狀，嚴重到意識不清、抑制呼吸系統、癲癇重積狀態，給予抗癲癇藥、類固醇、血漿置換、IVIG等治療。經治療後恢復意識，但四肢無力。上肢逐漸恢復運動，然而一直到出院時，T6-7以下仍全癱。病患出院後求診中醫治療，在大補氣血、大補陽、通經活絡兼化瘀的中醫治則下，病患慢慢地恢復感覺及運動。

Autoimmune encephalitis is a rare and severe disease with a low incidence rate, affecting 13.7 individuals per 100,000. In this case, a 27-year-old male initially presented with symptoms such as fever, headache, and visual discomfort. The fever and symptoms persisted without relief, leading to hospitalization through the emergency department five days after the onset. After another 5 days, the patient experienced confusion and persistent seizures, progressing to a state of impaired consciousness, respiratory suppression, and status epilepticus. Anti-epileptic drugs, steroids, plasma exchange, IVIG and other treatments were given. Following treatment, consciousness was restored, but the patient experienced limb weakness. While upper limb movement gradually recovered, the lower limbs remained paralyzed below T6-7 upon discharge. After being discharged from the hospital, the patient sought traditional Chinese medicine treatment. Under the TCM principles of replenishing qi and blood, reinforcing yang, dredging the meridians and removing blood stasis, the patient slowly recovered his sensation and movements.