Ikeda T, Yamanaka T, Fukushima T, Araki S
Department of Laboratory Medicine, Kumamoto University Medical School.
Rinsho Shinkeigaku. 1991 Sep;31(9):1032-4.
We reported a case with sequelae of SMON and painful tonic seizure (PTS). The patient was a 50-year-old woman. Onset of SMON was when she was 28 years old. She has been suffering from decreased sensation and dysesthesia below C8 cord level to a severe degree, gait disturbance to a moderate degree and visual disturbance to a slight degree. Since January 1990, she experienced stereotyped tonic seizures of all extremities and trunk without consciousness disturbance, preceded by tingling sensation ascending from bilateral distal legs, several times a day. During hospitalization, epilepsy, tetany and multiple sclerosis were ruled out and its seizures were completely depressed by oral administration of a small amount of carbamazepine. PTS which is said to be characteristic of multiple sclerosis is seldom found in SMON patients. This is a very important and interesting case to suggest a certain relation between the mechanism of PTS and the cord lesions of SMON.
我们报告了一例亚急性脊髓视神经病后遗症和痛性强直性发作(PTS)的病例。患者为一名50岁女性。亚急性脊髓视神经病于她28岁时发病。她一直患有C8脊髓节段以下严重的感觉减退和感觉异常、中度步态障碍以及轻度视觉障碍。自1990年1月起,她每天数次出现四肢和躯干的刻板性强直性发作,无意识障碍,发作前有从双侧小腿远端上升的刺痛感。住院期间,排除了癫痫、手足搐搦症和多发性硬化症,口服少量卡马西平后其发作完全得到抑制。据说多发性硬化症特征性的痛性强直性发作在亚急性脊髓视神经病患者中很少见。这是一个非常重要且有趣的病例,提示了痛性强直性发作机制与亚急性脊髓视神经病脊髓病变之间存在某种关联。