Tippett D S, Fishman P S, Panitch H S
Department of Neurology, University of Maryland School of Medicine, Baltimore 21201.
Neurology. 1991 May;41(5):703-6. doi: 10.1212/wnl.41.5.703.
Acute transverse myelitis is a monophasic disorder, the recurrence of which raises the question of multiple sclerosis (MS) or other multifocal CNS disease. We now report three patients with a previously undescribed syndrome of relapsing isolated acute transverse myelitis. Each had two to five attacks over periods of 3 to 8 years, characterized by ascending paresthesias, urinary retention, sensory loss with a thoracic or cervical level, paraparesis, hyperreflexia, and bilateral Babinski signs. MRI demonstrated areas of increased signal intensity on T2- and proton density-weighted scans and decreased signal intensity on T1-weighed scans of the cervical or thoracic spinal cord consistent with an inflammatory or demyelinating process. All patients had normal complete myelograms, oligoclonal IgG bands were consistently absent from the cerebrospinal fluid, cranial MRIs were normal, and there was no other clinical or laboratory evidence of MS, collagen-vascular disease, or active viral infection. They were treated with high doses of intravenous corticosteroids, stabilized between episodes, and had partial or complete recovery. The recognition of these three patients at a single medical center in a 1-year period suggests that relapses of acute transverse myelitis may not be rare.
急性横贯性脊髓炎是一种单相性疾病，其复发引发了多发性硬化（MS）或其他多灶性中枢神经系统疾病的问题。我们现在报告三例患有先前未描述的复发性孤立性急性横贯性脊髓炎综合征的患者。每位患者在3至8年的时间里发作了2至5次，其特征为感觉异常上升、尿潴留、胸段或颈段水平的感觉丧失、轻瘫、反射亢进和双侧巴宾斯基征。MRI显示在颈段或胸段脊髓的T2加权和质子密度加权扫描上信号强度增加，在T1加权扫描上信号强度降低，这与炎症或脱髓鞘过程一致。所有患者的全脊髓造影均正常，脑脊液中始终未检测到寡克隆IgG带，头颅MRI正常，且没有其他MS、胶原血管病或活动性病毒感染的临床或实验室证据。他们接受了大剂量静脉注射皮质类固醇治疗，发作间期病情稳定，部分或完全康复。在1年时间内在单一医疗中心识别出这三例患者表明急性横贯性脊髓炎的复发可能并不罕见。
