Bentes C, de Carvalho M, de Sá J, Luís M L
Department of Neurology, Hospital de Santa Maria, Lisbon, Portugal.
Electromyogr Clin Neurophysiol. 1999 Jan-Feb;39(1):33-7.
The association of central and peripheral demyelination was reported previously. Most of the cases refer to central chronic relapsing demyelination with clinical criteria for multiple sclerosis associated with later signs of peripheral nerve involvement. Other authors, described central lesions in patients with chronic inflammatory demyelinating polyneuropathy and in Guillain-Barré syndrome, as a seldom occurrence. We report a patient in which a chronic steadily progressive central and peripheral predominantly motor nervous system demyelination, involving the cranial nerves, was identified. The patient improved after intravenous immunoglobulin suggesting an immune-mediated mechanism. To our knowledge this presentation was not described before.
此前曾报道过中枢和周围脱髓鞘的关联。大多数病例是指中枢性慢性复发性脱髓鞘,伴有多发性硬化的临床标准,并伴有周围神经受累的后期体征。其他作者描述了慢性炎症性脱髓鞘性多发性神经病和吉兰-巴雷综合征患者出现中枢性病变的情况较为少见。我们报告了一例患者,其存在慢性进行性中枢和周围主要运动神经系统脱髓鞘,累及颅神经。该患者在静脉注射免疫球蛋白后病情改善,提示存在免疫介导机制。据我们所知,此前尚未描述过这种表现。