Fukae Jiro, Noda Kazuyuki, Fujishima Kenji, Takahashi Toshiyuki, Hattori Nobutaka, Okuma Yasuyuki
Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka.
Intern Med. 2010;49(4):343-7. doi: 10.2169/internalmedicine.49.2175. Epub 2010 Feb 15.
In neuro-Behcet's disease (NBD), myelitis is a rare clinical form. We report the case of a woman with NBD presenting with unsteady gait and generalized spasticity. Spinal magnetic resonance imaging (MRI) showed multiple and confluent hyperintensities extending throughout the entire spinal cord on a T2-weighted image with some contrast enhancement. High-dose steroid therapy was so effective that the myelitis was markedly improved, as shown in the follow-up MRI. Longitudinal myelitis involving the entire spinal cord, as seen in our patient, has never been described before. This case suggests that NBD could be one of the important differential diagnoses of longitudinal myelitis.
在神经白塞病(NBD)中,脊髓炎是一种罕见的临床类型。我们报告一例患有NBD的女性患者,表现为步态不稳和全身性痉挛。脊髓磁共振成像(MRI)显示,在T2加权图像上,多个融合性高信号影贯穿整个脊髓,并有一些强化。高剂量类固醇治疗效果显著,脊髓炎在后续MRI检查中明显改善。如我们患者所见,累及整个脊髓的纵向脊髓炎此前从未有过描述。该病例提示,NBD可能是纵向脊髓炎重要的鉴别诊断之一。