Shefner J M, Mackin G A, Dawson D M
Neurology Division, Brigham and Women's Hospital, Boston, MA 02115.
Muscle Nerve. 1992 Nov;15(11):1265-70. doi: 10.1002/mus.880151108.
A patient in whom multiple sclerosis (MS) was ultimately diagnosed presented with a lower motor neuron syndrome involving 1 hand, with EMG evidence of denervation. Twelve other patients were subsequently identified with definite MS and asymmetric hand atrophy. These patients were studied clinically and electrophysiologically. Evidence of chronic and ongoing denervation was noted in the hands of 12 of the 13 patients; in only 3 patients could the EMG abnormalities be accounted for by peripheral nerve lesions. Thus, lesions resulting in lower motor neuron damage may occur in the central nervous system in MS patients. We suggest that demyelination in the region of the ventral root exit zone may account for these findings.
一名最终被诊断为多发性硬化症（MS）的患者出现了累及一只手的下运动神经元综合征，肌电图显示有去神经支配的证据。随后又确定了另外12名患有明确MS且手部不对称萎缩的患者。对这些患者进行了临床和电生理研究。在13名患者中的12名患者的手部发现了慢性和持续性去神经支配的证据；只有3名患者的肌电图异常可归因于周围神经病变。因此，MS患者的中枢神经系统可能会出现导致下运动神经元损伤的病变。我们认为腹根出口区的脱髓鞘可能是这些发现的原因。
