Ono S, Okuzawa S, Shimizu N, Shimizu N, Nagao K
Rinsho Shinkeigaku. 1989 Apr;29(4):500-4.
A case of Sjögren-Larsson syndrome (SLS) with peripheral nerve involvement was described. A patient was a 37-year-old man with marked mental retardation who had ichthyosis since several months of age. He developed spastic gait at age 20 and noticed muscle weakness and atrophy in lower extremities at age 30. On examination, electromyogram showed neurogenic changes with polyphasic motor unit potentials of high amplitude and long duration, and motor and sensory conduction velocities were slightly decreased in lower extremities. Muscle biopsy specimens of the left quadriceps showed grouped atrophy and pyknotic nuclear clumps, suggestive of neurogenic changes. Left sural nerve biopsy showed decreased number of myelinated fibers. On electron microscopy, some myelinated fibers revealed proliferation of the organelles in axons with disruption of the myelin sheath, and glycogen granules in Schwann cell cytoplasm. Unmyelinated fibers showed no reduction in the density, but accompanied numerous collagen pockets and Schwann cell cytoplasmic processes arranged in many stacks, suggesting the presence of some degenerative changes. With the present findings at peripheral level and a review of the literature, we may assume that SLS has extensive disorders of the ectodermal tissues including the peripheral nerve as well as the skin and the central nervous system.
报告1例伴有周围神经受累的舍格伦-拉尔松综合征(SLS)。患者为一名37岁男性,自幼患鱼鳞病,有明显智力发育迟缓。20岁时出现痉挛性步态,30岁时发现下肢肌肉无力和萎缩。检查时,肌电图显示神经源性改变,运动单位电位多相、波幅高、时限长,下肢运动和感觉传导速度略有降低。左股四头肌肌肉活检标本显示群组性萎缩和核固缩团块,提示神经源性改变。左腓肠神经活检显示有髓纤维数量减少。电镜检查显示,一些有髓纤维轴突内细胞器增生,髓鞘破坏,施万细胞胞质内可见糖原颗粒。无髓纤维密度未见降低,但伴有大量胶原小囊和呈多层排列的施万细胞胞质突起,提示存在一些退行性改变。结合目前周围神经水平的检查结果并复习文献,我们推测SLS存在包括周围神经、皮肤及中枢神经系统在内的广泛外胚层组织病变。