伴有多种脑干表现的视神经脊髓炎谱系障碍：一例报告
Neuromyelitis optica spectrum disorders with multiple brainstem manifestations: a case report.
作者信息
Li Yao, Jiang Bin, Chen Bin, Zhao Mingxia, Zhou Chunlai, Wang Shuhui, Li Jimei, Wang Ruijin
机构信息
Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
出版信息
Neurol Sci. 2016 Feb;37(2):309-13. doi: 10.1007/s10072-015-2196-z. Epub 2015 Apr 3.
BACKGROUND
Multiple brainstem manifestations have been rarely reported during the same attack in neuromyelitis optica spectrum disorders (NMOSD).
CASE PRESENTATION
We describe a 39-year-old Asian woman presenting multiple brainstem manifestations including intractable nausea and vomiting, vertigo, diplopia, facial palsy, hypogeusia, ophthalmoplegia, hemiplegia, dysphagia and tonic spasm during the same attack. Hypogeusia was transient and recovered without any immunotherapy. The brain MRIs showed progressive multiple lesions in the brainstem. NMO-IgG (aquaporin4-antibody, AQP4-Ab) were positive in both serum and cerebral spinal fluid. The symptoms and signs were controlled after immunosuppressive therapy. No relapse happened during the 15-month follow-up.
CONCLUSION
This report emphasizes multiple brainstem manifestations during the same attack in NMOSD and the most characteristic symptom was reversible hypogeusia.
背景
视神经脊髓炎谱系障碍（NMOSD）在同一次发作期间出现多种脑干表现的情况鲜有报道。
病例报告
我们描述了一名39岁的亚洲女性，在同一次发作期间出现多种脑干表现，包括顽固性恶心和呕吐、眩晕、复视、面瘫、味觉减退、眼肌麻痹、偏瘫、吞咽困难和强直性痉挛。味觉减退是短暂的，未经任何免疫治疗即恢复。脑部磁共振成像显示脑干有进行性多发病变。血清和脑脊液中的NMO-IgG（水通道蛋白4抗体，AQP4-Ab）均为阳性。免疫抑制治疗后症状和体征得到控制。在15个月的随访期间未发生复发。
结论
本报告强调了NMOSD在同一次发作期间出现的多种脑干表现，最具特征性的症状是可逆性味觉减退。
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