Rilling G, Fretz C, Ludin H P
Klinik für Neurologie, Kantonsspital St. Gallen.
Praxis (Bern 1994). 1999 Dec 9;88(50):2071-6.
Two female patients with recurrent optic neuritis and severe myelitis were described. In the first patient the illness began with recurrent myelitis, in the second one with optic neuritis. In both patients spinal MRI showed extensive enhancing lesions of the cervical respectively thoracic spinal cord. An initial cranial MRI was normal. In the first patient an MRJ demonstrated after several years lesions not typical for multiple sclerosis. In both patients cerebrospinal fluid showed especially mononuclear pleocytosis with cell counts between 11 and 126/microliter and severely elevated total protein, while intrathecal oligoclonal bands were not found. During exacerbations in both patients ENA-autoantibody-screening was positive. Intravenous treatment with methylprednisolone improved the clinical situation for some time. In both patients cyclophosphamide at a dose of 100 mg daily had to be given due to relapsing neurological deficits.
描述了两名患有复发性视神经炎和严重脊髓炎的女性患者。第一名患者的疾病始于复发性脊髓炎,第二名患者始于视神经炎。两名患者的脊柱磁共振成像(MRI)均显示颈段或胸段脊髓有广泛的强化病灶。初次头颅MRI正常。第一名患者在数年后的磁共振成像(MRJ)显示出非典型的多发性硬化病灶。两名患者的脑脊液均显示特别是单核细胞增多,细胞计数在11至126/微升之间,总蛋白严重升高,而未发现鞘内寡克隆带。两名患者病情加重期间,可提取核抗原(ENA)自身抗体筛查呈阳性。静脉注射甲基泼尼松龙在一段时间内改善了临床状况。由于神经功能缺损复发,两名患者均不得不每日给予100毫克剂量的环磷酰胺。