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[一例伴有下丘脑性闭经的多发性硬化症病例]

[A case of multiple sclerosis with hypothalamic amenorrhea].

作者信息

Miyamoto T, Miyamoto M, Yokota N, Kubo J, Hirata K

机构信息

Department of Neurology, Dokkyo University School of Medicine.

出版信息

Rinsho Shinkeigaku. 2000 Mar;40(3):263-7.

Abstract

We present a 31-year-old woman of multiple sclerosis. At age 28, she was admitted with complaints of echolalia and a gradual onset of weakness affecting the right upper and bilateral lower limbs. Brain MRI showed high intensity areas in the bilateral frontal gyri, lobuli paracentralis, and left anterior thalamus. Although she had been in remission for 3 years, she developed dysesthesia of left upper and lower limbs. Cervical T2 weighted MRI showed a new high signal intensity lesion in the spinal cord from the C2 to C3 level. The combination of the cerebral, thalamic and spinal cord lesions with remission and excerbations allowed the diagnosis of clinically MS to be made. She suffered amenorrhea from the onset of her illness. Serum prolactin was within the normal range. The LH and FSH basal secretions were decreased and there were low delayed secretions of LH and FSH after intravenous injection of 100 micrograms LHRH. We consider that her amenorrhea was caused by the hypothalamic lesion, supported by MR findings of dilatation of the third ventricle.

摘要

我们报告一名31岁的多发性硬化症女性患者。28岁时,她因言语模仿症以及右上肢和双侧下肢逐渐出现无力症状而入院。脑部磁共振成像(MRI)显示双侧额回、中央旁小叶和左侧丘脑前部有高强度区域。尽管她已缓解3年,但左上肢和下肢仍出现感觉异常。颈椎T2加权MRI显示脊髓C2至C3水平有新的高信号强度病变。脑部、丘脑和脊髓病变伴有缓解和复发,从而得以做出临床多发性硬化症的诊断。她自患病起就出现闭经。血清催乳素在正常范围内。促黄体生成素(LH)和促卵泡生成素(FSH)的基础分泌减少,静脉注射100微克促性腺激素释放激素(LHRH)后,LH和FSH的延迟分泌也较低。我们认为她的闭经是由下丘脑病变引起的,第三脑室扩张的MRI表现支持这一观点。

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