el Alaoui-Faris M, Medejel A, al Zemmouri K, Yahyaoui M, Chkili T
Service de Neurologie, Hôpital des spécialités Rabat, Maroc.
Rev Neurol (Paris). 1990;146(1):41-4.
We studied 5 cases of syphilitic lateral amyotrophic sclerosis. The diagnosis was based on the presence of a lymphocytic reaction in the CSF and positive VDRL and TPHA reactions in both blood and CSF. Clinically, the disease affected the arms in 3 cases and produced paraplegia in 2 cases. The gradual extension of amyotrophy over several months, the diffusion of electromyographic abnormalities and the finding of spinal cord atrophy at myelography and CT suggested a subacute ischemic mechanism with meningo-myelic arteritis involving the anterior horns. After treatment with penicillin G in high doses, the outcome was constantly favourable, with improvement of motor deficit in 4 cases and stabilisation in 1 case in a 5 to 13 years' follow-up.
我们研究了5例梅毒性侧索肌萎缩症。诊断依据是脑脊液中存在淋巴细胞反应,血液和脑脊液中的性病研究实验室玻片试验(VDRL)及梅毒螺旋体血凝试验(TPHA)均呈阳性。临床上,3例患者手臂受累,2例出现截瘫。数月来肌萎缩逐渐加重,肌电图异常扩散,脊髓造影和CT检查发现脊髓萎缩,提示存在一种亚急性缺血机制,伴有累及前角的脑脊膜炎性动脉炎。大剂量青霉素G治疗后,在5至13年的随访中,结果始终良好,4例运动功能缺损改善,1例病情稳定。