Shioyama Mitsuaki, Akamatsu Maiko, Mitsui Yoshiyuki, Sada Masami, Hirakawa Minako, Kusunoki Susumu
Department of Neurology, Kinki University School of Medicine.
Rinsho Shinkeigaku. 2006 Oct;46(10):722-4.
A 54-year-old-man experienced pain from his left shoulder to his left arm and had difficulty in lifting his arm after a febrile episode. Three weeks after the onset, he was admitted to our hospital. Neurological examination demonstrated weakness and atrophy of the left deltoid muscle. Deep tendon reflexes were normal and no pathological reflexes were elicited. CSF total protein was slightly increased. The occurrence rate of F-waves was decreased in the left upper limb. Magnetic resonance imaging (MRI) study of the cervical cord and brachial plexus with and without Gadolinium infusion showed no abnormalities. Serological study showed that IgM anticytomegalovirus antibody was positive, and that serum IgM anti-GalNAc-GD1a antibody and IgM anti-GM2 antibody were positive. Symptoms were improved after treatment with mecobalamin, 1.5mg/day. This case was considered neuralgic amyotrophy after cytomegalovirus infection. The antiganglioside antibodies may play some role in its pathogenesis.
一名54岁男性在发热发作后出现从左肩至左臂的疼痛，且抬臂困难。发病三周后，他入住我院。神经学检查显示左侧三角肌无力和萎缩。深部腱反射正常，未引出病理反射。脑脊液总蛋白略有升高。左上肢F波出现率降低。颈椎和臂丛神经的磁共振成像（MRI）研究，无论有无钆增强，均未显示异常。血清学研究表明，IgM抗巨细胞病毒抗体呈阳性，血清IgM抗GalNAc-GD1a抗体和IgM抗GM2抗体也呈阳性。每天服用1.5mg甲钴胺治疗后症状有所改善。该病例被认为是巨细胞病毒感染后的神经性肌萎缩。抗神经节苷脂抗体可能在其发病机制中起一定作用。
