Kwan S Y, Lin J H, Su M S
Section of Epilepsy, Taipei Veterans General Hospital, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 2000 Feb;63(2):153-7.
We report the case of a 36-year-old Chinese man with a history of complex partial seizure of temporal lobe origin since the age of 12 years, superimposed by myasthenia gravis since the age of 27 years and psoriasis vulgaris since the age of 29 years. With an eight-year follow-up, the above three diseases remained without complete remission. Anticonvulsant therapy (phenytoin and trimethadione) caused drug-induced myasthenia gravis, which should gradually disappear after discontinuing the drugs. However, the myasthenic symptoms and serum acetylcholine receptor antibody persisted following the discontinuation of phenytoin in our patient. Myasthenia gravis and psoriasis are both autoimmune diseases and correlate with specific human histocompatibility antigens. This suggests a close connection between these two diseases. The coexistence of epilepsy, myasthenia gravis and psoriasis vulgaris has not been previously reported, and to the best of our knowledge, our patient is the first reported case. The relationship among these three diseases requires further investigation.
我们报告了一例36岁的中国男性病例，该患者自12岁起患有颞叶起源的复杂部分性癫痫，自27岁起叠加重症肌无力，自29岁起患有寻常型银屑病。经过八年的随访，上述三种疾病均未完全缓解。抗惊厥治疗（苯妥英钠和三甲双酮）导致了药物性重症肌无力，停药后这种情况应逐渐消失。然而，在我们的患者停用苯妥英钠后，重症肌无力症状和血清乙酰胆碱受体抗体仍然存在。重症肌无力和银屑病都是自身免疫性疾病，且与特定的人类组织相容性抗原相关。这表明这两种疾病之间存在密切联系。癫痫、重症肌无力和寻常型银屑病并存的情况此前未见报道，据我们所知，我们的患者是首例报告病例。这三种疾病之间的关系需要进一步研究。
