上海医药
上海醫藥
상해의약
SHANGHAI MEDICAL & PHARMACEUTICAL JOURNAL
2014年
11期
28-30
,共3页
视神经脊髓炎谱系病%核磁共振%水通道蛋白4
視神經脊髓炎譜繫病%覈磁共振%水通道蛋白4
시신경척수염보계병%핵자공진%수통도단백4
neuromyelitis optica spectrum disorder%aquaporin 4%magnetic resonance imaging
目的：报告少见的核磁共振（MRI）阴性的视神经脊髓炎谱系病（NMOSD）1例。方法：对1例MRI阴性的NMOSD患者的临床资料进行回顾性总结。结果：女患者于2012年9月曾因视神经炎口服强的松后好转。2013年1月因顽固性呃逆、呕吐住我院，查血水通道蛋白4（AQP4）抗体呈强阳性，头颅及脊髓MRI检查均阴性，消化系统检查无异常发现，结合“视神经炎”病史，诊断为NMOSD，予甲强龙冲击治疗后呕吐呃逆消失。结论：顽固性呃逆、呕吐是NMOSD的特异性症状，为脑干背侧呕吐中枢受累所致，但有时头颅MRI未必在相应部位有所发现，此时仍应警惕NMOSD的可能。
目的：報告少見的覈磁共振（MRI）陰性的視神經脊髓炎譜繫病（NMOSD）1例。方法：對1例MRI陰性的NMOSD患者的臨床資料進行迴顧性總結。結果：女患者于2012年9月曾因視神經炎口服彊的鬆後好轉。2013年1月因頑固性呃逆、嘔吐住我院，查血水通道蛋白4（AQP4）抗體呈彊暘性，頭顱及脊髓MRI檢查均陰性，消化繫統檢查無異常髮現，結閤“視神經炎”病史，診斷為NMOSD，予甲彊龍遲擊治療後嘔吐呃逆消失。結論：頑固性呃逆、嘔吐是NMOSD的特異性癥狀，為腦榦揹側嘔吐中樞受纍所緻，但有時頭顱MRI未必在相應部位有所髮現，此時仍應警惕NMOSD的可能。
목적：보고소견적핵자공진（MRI）음성적시신경척수염보계병（NMOSD）1례。방법：대1례MRI음성적NMOSD환자적림상자료진행회고성총결。결과：녀환자우2012년9월증인시신경염구복강적송후호전。2013년1월인완고성애역、구토주아원，사혈수통도단백4（AQP4）항체정강양성，두로급척수MRI검사균음성，소화계통검사무이상발현，결합“시신경염”병사，진단위NMOSD，여갑강룡충격치료후구토애역소실。결론：완고성애역、구토시NMOSD적특이성증상，위뇌간배측구토중추수루소치，단유시두로MRI미필재상응부위유소발현，차시잉응경척NMOSD적가능。
Objective:To report a rare case of neuromylitis optica spectrum disorder (NMOSD) with normal brain and spinal cord MRI images. Methods: Clinical data on a patient with NMOSD but without positive findings on MRI were retrospectively summarized. Results:A 30 years old female had suffered from optic neuritis in September 2012 but was improved after treatment with oral prednisone. In January 2013 she was hospitalized again because of intractable hiccups, vomiting. Serum AQP-4 antibody was strongly positive, while cranial and spinal MRI were normal and examinations of digestive system showed no abnormalities. She was diagnosed as NMOSD, and the hiccups and vomiting disappeared after pulse therapy with high-dose methylprednisolone. Conclusion:Intractable hiccups, vomiting are characteristic symptoms of NMOSD due to the lesions in dorsal brainstem. Sometimes these lesions would not cause alterations of MRI signals, however, the possibilities of NMOSD should still be kept in mind.
