Rajabally Yusuf A, Knopp Michael J, Martin-Lamb Darren, Morlese John
Department of Neurology, University Hospitals of Leicester, Leicester, United Kingdom; Department of Neurophysiology, University Hospitals of Leicester, Leicester, United Kingdom.
Department of Neurology, University Hospitals of Leicester, Leicester, United Kingdom.
J Neurol Sci. 2014 Jul 15;342(1-2):182-5. doi: 10.1016/j.jns.2014.04.033. Epub 2014 Apr 30.
Lewis-Sumner syndrome (LSS) is considered a variant of chronic inflammatory demyelinating polyneuropathy (CIDP), which is more frequently described with exclusive upper limb involvement. The diagnosis of LSS is clinical and electrophysiological. However, these are not always obvious and in view of its rarity, the diagnosis may be missed and patients denied effective immunomodulatory therapy. We herein describe the magnetic resonance imaging (MRI) findings in a series of five consecutive patients with a clinical diagnosis of LSS, using T2 STIR (Short Tau Inversion recovery) images without contrast. We demonstrated hyperintensity with or without hypertrophy of cervical roots and/or brachial plexus on the affected side and/or controlaterally which aided diagnostic confirmation. This helped therapeutic decision making regarding immunotherapy in all cases. MR imaging of the cervical spine/brachial plexus with T2 STIR may be helpful in suspected cases of LSS as it represents a very useful additional diagnostic tool.
刘易斯-萨姆纳综合征（LSS）被认为是慢性炎症性脱髓鞘性多发性神经病（CIDP）的一种变异型，其更常被描述为仅累及上肢。LSS的诊断依靠临床和电生理检查。然而，这些表现并不总是很明显，鉴于其罕见性，可能会漏诊，患者也无法得到有效的免疫调节治疗。我们在此描述了连续5例临床诊断为LSS患者的磁共振成像（MRI）表现，使用的是无造影剂的T2加权短反转恢复（STIR）序列图像。我们发现，患侧和/或对侧的颈神经根和/或臂丛神经出现高信号，伴或不伴有增粗，这有助于确诊。这有助于在所有病例中做出关于免疫治疗的决策。对于疑似LSS的病例，采用T2加权STIR序列对颈椎/臂丛神经进行磁共振成像检查可能会有帮助，因为它是一种非常有用的辅助诊断工具。
