Shiote Mito, Kido Yukiko, Hayashi Takeshi, Manabe Yasuhiro, Kashihara Ken-ichi, Nagano Isao, Shoji Mikio, Abe Koji
Department of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
No To Shinkei. 2003 Jun;55(6):521-5.
We reported a 45-year-old man who had repeated isolated thoracic spinal cord lesion on MRI in the clinical course of seven years. He had transient bilateral plantar numbness and urinary retention on December, 1994. Then, spastic paraplegia, total anesthesia of feet, and severe sphincter disturbance struck him on May, 1995. He was diagnosed as incomplete Behçet's disease and neuro-Behçet's disease on June, 1995 because of recurrent oral aphta, genital ulceration, and foliculitis. T2-weighted magnetic resonance imaging showed high intensity enhanced with Gd-DTPA in thoracic spinal cord from Th 5 to 8 level. Any other abnormal lesion on brain or spinal MRI was not observed. He was treated with corticosteroids and recovered incompletely. Another two big attacks occurred to him. No new lesion but thoracic spinal cord lesion was observed. We conclude that this case is the first reported example of neuro-Behçet's disease with repeating isolated thoracic spinal cord lesion.
我们报告了一名45岁男性,在7年的临床病程中,MRI检查发现其胸椎脊髓反复出现孤立性病变。1994年12月,他出现短暂的双侧足底麻木和尿潴留。1995年5月,他又出现痉挛性截瘫、足部完全麻醉以及严重的括约肌功能障碍。1995年6月,由于反复出现口腔溃疡、生殖器溃疡和毛囊炎,他被诊断为不完全型白塞病和神经白塞病。T2加权磁共振成像显示,胸段脊髓从T5至T8水平有高强度信号,注射钆喷酸葡胺后强化。脑部或脊髓MRI未发现其他异常病变。他接受了皮质类固醇治疗,但恢复不完全。他又发作了两次严重病情。未观察到新的病变,仅存在胸段脊髓病变。我们得出结论,该病例是首例报告的反复出现孤立性胸段脊髓病变的神经白塞病。