Itoh K, Kawai S, Nishino M, Lee Y, Negishi H, Itoh H
Department of Pediatrics, Takatsuki General Hospital.
No To Hattatsu. 1992 May;24(3):283-8.
The clinical and pathological features of siblings with infantile neuroaxonal dystrophy were reported. Early clinical symptoms were marked hypotonia in legs, mental regression and poor vision. Laboratory data were normal except for the mild elevation of GOT and LDH in serum and cerebrospinal fluid. MRI showed progressive atrophy of cerebellar vermis and brainstem. EEG showed a progressive increase in the amount and amplitude of the fast activities over the age of 3 years. Auditory brainstem response (ABR) showed progressive worsening with no response by 2 years and 6 months. Somatosensory evoked potentials (SEP) showed no cortical response by 4 years. Nerve conduction velocity (NCV) of both motor and sensory nerves was within normal limits. Pathologically, spheroid bodies were found in the axons of central and peripheral nerves, remarkably in brainstem and dorsal column. MRI, ABR and SEP findings were clinically useful, suggestive of the degeneration of brainstem.
报道了患有婴儿神经轴索性营养不良的兄弟姐妹的临床和病理特征。早期临床症状为腿部明显肌张力减退、智力衰退和视力不佳。实验室检查数据除血清和脑脊液中谷草转氨酶(GOT)和乳酸脱氢酶(LDH)轻度升高外均正常。磁共振成像(MRI)显示小脑蚓部和脑干进行性萎缩。脑电图(EEG)显示3岁以上快速活动的数量和幅度逐渐增加。听觉脑干反应(ABR)显示逐渐恶化,在2岁6个月时无反应。体感诱发电位(SEP)在4岁时无皮层反应。运动和感觉神经的神经传导速度(NCV)均在正常范围内。病理上,在中枢和周围神经的轴突中发现了球形小体,在脑干和后索尤为明显。MRI、ABR和SEP结果在临床上很有用,提示脑干变性。