Kutoku Yumiko, Kurokawa Katsumi, Murakami Tatsufumi, Sunada Yoshihide
Department of Neurology, Kawasaki Medical School.
Rinsho Shinkeigaku. 2009 Oct;49(10):664-6. doi: 10.5692/clinicalneurol.49.664.
A 77-year-old woman was admitted with a chief complaint of tingling sensation in the both feet, which gradually developed just after the diagnosis of Castleman disease was made. Neurological examination showed mild weakness in the neck and pelvic girdle muscles, and sensory impairment affecting all modalities in the lower legs. Although these neurological findings suggest a diagnosis of neuropathy, nerve conduction studies (NCS) and F-wave disclosed no abnormalities. However, the short latency somatosensory evoked potential (S-SEP) in the tibial nerve revealed a significant delay in the P15 latency, which is indicative of neuropathy affecting proximal potion of the peripheral nerve. To our knowledge, only a few reports described proximal neuropathy associated with Castleman disease. In our case, the examination of S-SEP was very informative to make a diagnosis of neuropathy.
一名77岁女性因双足刺痛感为主诉入院,该症状在Castleman病确诊后不久逐渐出现。神经系统检查显示颈部和骨盆带肌肉轻度无力,小腿所有感觉模式均有感觉障碍。尽管这些神经学表现提示为神经病变,但神经传导研究(NCS)和F波检查未发现异常。然而,胫神经的短潜伏期体感诱发电位(S-SEP)显示P15潜伏期显著延迟,这表明存在影响周围神经近端部分的神经病变。据我们所知,仅有少数报告描述了与Castleman病相关的近端神经病变。在我们的病例中,S-SEP检查对于诊断神经病变非常有帮助。