Nakano T, Awaki E, Araga S, Takai H, Inoue K, Takahashi K
Division of Neurology, Tottori University, Yonago, Japan.
Acta Neurol Scand. 1992 May;85(5):372-5. doi: 10.1111/j.1600-0404.1992.tb04064.x.
Recurrent herpes zoster myelitis is very rare. However, a case was recently observed in our hospital. A 43-year-old woman developed myelitis 2 weeks after development of shingles. Her condition was improved by methylprednisolone. Seven months later, she developed myelitis after development of shingles again. Antibody against varicella-zoster (VZV), increased in the serum, but was negative in the cerebrospinal fluid. Methylprednisolone was not sufficiently effective against this attack. The refractory sensory disturbance was improved by human interferon alpha (IFN-alpha). Natural killer cell activity, the helper T-cell/suppressor T-cell ratio and the kappa/lambda ratio of B-cells increased with clinical improvement. In this case, delayed-type hypersensitivity after VZV infection played a role in the occurrence of myelopathy and clinical improvement resulted from the immunosuppressive effects of IFN-alpha.
复发性带状疱疹性脊髓炎非常罕见。然而，我院最近观察到一例。一名43岁女性在带状疱疹发作2周后发生脊髓炎。她的病情通过甲泼尼龙得到改善。7个月后，她再次在带状疱疹发作后发生脊髓炎。水痘-带状疱疹病毒（VZV）抗体在血清中升高，但在脑脊液中为阴性。甲泼尼龙对此次发作的疗效不佳。人α干扰素（IFN-α）改善了难治性感觉障碍。随着临床症状改善，自然杀伤细胞活性、辅助性T细胞/抑制性T细胞比值以及B细胞的κ/λ比值升高。在该病例中，VZV感染后的迟发型超敏反应在脊髓病的发生中起作用，而临床改善是由于IFN-α的免疫抑制作用。
