Linoli G, Tomelleri G, Ghezzi M
Unità Operativa di Neurologia, USL 23 di Arezzo.
Pathologica. 1991 May-Jun;83(1085):325-34.
A sporadic case of oculopharyngeal muscular dystrophy occurred in a 74-year-old woman is described. High levels of IgA and IgG in the serum, and esophageal smooth muscle involvement are shown. Electromyography of several limb muscles displayed myopathic pattern with giant polyphasic motor unit potentials, suggesting superimposed denervation. The histological examination of peroneus brevis muscle biopsy specimen showed myopathic changes with dystrophic features, associated with neurogenic changes, including atrophic angulated fibers, small-group atrophy and type-grouping: concomitant involvement of spinal motor neuron pathway is hypotized, normal values of motor and sensory nerve conduction velocities excluding associated polineuropathy. Furthermore, Somatosensory Evoked Potentials recording revealed bilaterally increased Central Conduction Time. Referring to other similar cases previously reported in the literature, the significance of neurogenic involvement in oculopharyngeal muscular dystrophy is discussed.
本文描述了一例发生在一名74岁女性身上的散发性眼咽型肌营养不良病例。血清中IgA和IgG水平升高,且存在食管平滑肌受累情况。对几块肢体肌肉进行的肌电图检查显示为肌病模式,伴有巨大多相运动单位电位,提示存在叠加性失神经支配。对腓骨短肌活检标本进行的组织学检查显示有肌病性改变并伴有营养不良特征,同时伴有神经源性改变,包括萎缩成角纤维、小群萎缩和群组化:推测脊髓运动神经元通路也受到了累及,运动和感觉神经传导速度的正常值排除了相关的多发性神经病。此外,体感诱发电位记录显示双侧中枢传导时间延长。参照先前文献中报道的其他类似病例,讨论了神经源性受累在眼咽型肌营养不良中的意义。