神經科專科醫師 彭嚴毅
mailto:yypeng@ms4.hinet.net
mailto:yypeng@tpts1.seed.net.tw
http://www.geocities.com/HotSprings6179/

Q大陸求救信如下:
An Urgent Appeal For Help (English version of the SOS provided by some warm-hearted friends.) Zhang Xili, an 8-year-old clever boy, is a Grade 2 student in Hangzhou Shenli Primary School. He was affected by right side upper parotitis in a student's home on Dec. 26, 1998.

Banlangen and anti-virus medicine were taken on the same day. His right ear was found deaf on 28th. He felt headache on 29th and 30th with dizzy and omit symptoms, but with no obvious fever. Zhejiang Provincial Children Hospital on 31st judged as light encephalitis, therefore he began to live in the hospital. On 4th of Jan., the encephalitis symptoms disappeared and he was transferred to Zhejiang Provincial No. 2 Hospital and was judged as neuro-deaf generated from virus.

Treating method: injecting nutrition nerve VB 12 etc., anti-virus medicine. Auxiliary treatment: acupuncture for 18 days, high oxygen room for 10 days, taking predinsone for 10 days.

After one-month treatment, the right ear test is stilling 0 with tinnitus. As the disease was found early, there is still hope for cure it. The parents are so desperate that they wish to ask help from Internet for any assistance or relevant treating evidence.

It is grateful if anyone who knows anything about this disease can contact the boy's mother at 0086 571 6090395(home) or (0) 138 5738668. Email:george@zg169.net Homepageㄩhttp://www.zg169.net/~george/newpage2.htm

A神經科專科醫師彭嚴毅回答:
  因為這樣的資料仍然包含各種可能的病,所以很難給詳細的建議,如果對病患是那一種病尚且無法確定,詳細的治療 更難。一般說來,要有醫療工作者的病歷摘要,才會對病情能有深入的了解。
  如果說腦炎(encephalitis),那我就會就想要知道:腦脊髓液檢查(CSF),腦波檢查,腦部影像檢查等等,血清檢 查?

  又懷疑那一種病毒?是腮腺炎(Mumps)?
Mumps, acute purulent meningitis (particularly influenzal), or chronic infection spreading from the middle to the inner ear may cause nerve deafness in childhood. It is uncertain whether the deafness in these cases is due to direct infection or represents an autoimmune reaction of the inner ear. In a prospective study of 88 cases of acute sensorineural hearing loss, two-thirds recovered their hearing completely within a few days or a week or two (Mattox and Simmons). None of the currently popular therapeutic agents, such as histamine and steroids, seemed to affect the outcome. In the remaining patients, recovery was much slower and often incomplete.

節錄自 Principles of Neurology Adams Copyright c 1998 McGraw-Hill.

  從上述的治療也許可以知道治療的醫師在想甚麼,應該是很努力在治療,可是遺憾的是若說是病毒,目前經過證明有效 的治療方法並不多,所以病人將來的預後如果要說多是自己復原的似乎也不能說不對。
  若是病毒性腦炎我照顧也沒把握會更好吧!如果有新的且實驗證實的治療法,在今日資訊傳遞迅速的時代,只要勤勞的 醫師都會知道的,不一定就是要已開發國家的醫師才知道。
  未經實驗證實的治療法其實是很多的,一個醫師得要有判斷能力。例如上述的治療法,我都沒有異議,但也沒有一項我 可以確定有效或我可以為它背書的,當然實際上我也會使用到其中幾種。