Verma Rajesh, Praharaj Heramba Narayan
Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India.
BMJ Case Rep. 2012 Jul 9;2012:bcr0320126138. doi: 10.1136/bcr-03-2012-6138.
Arnold-Chiari malformations are a group of congenital or acquired defects associated with the displacement of cerebellar tonsils into the spinal canal. First described by Chiari (1891), this has various grades of severity and involves various parts of neuraxis, for example, cerebellum and its outputs, neuro-otological system, lower cranial nerves, spinal sensory and motor pathways. The symptomatology of Arnold-Chiari malformations may mimic multiple sclerosis, primary headache syndromes, spinal tumours and benign intracranial hypertension. We highlighted a case of Chiari type I malformation, who presented with posterolateral ataxia associated with significant vitamin B(12) deficiency. The patient was supplemented with vitamin B(12) injections and showed remarkable improvement at follow-up after 3 months.
阿诺德-奇阿利畸形是一组先天性或后天性缺陷,与小脑扁桃体移位至椎管有关。该畸形由奇阿利于1891年首次描述,有不同程度的严重程度,累及神经轴的各个部分,例如小脑及其传出纤维、神经耳科系统、低位颅神经、脊髓感觉和运动通路。阿诺德-奇阿利畸形的症状可能类似多发性硬化症、原发性头痛综合征、脊髓肿瘤和良性颅内高压。我们重点介绍了一例Ⅰ型奇阿利畸形病例,该患者表现为后外侧共济失调,并伴有严重的维生素B12缺乏。患者接受了维生素B12注射补充治疗,在3个月后的随访中显示出显著改善。