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脊髓损伤后发生多发性硬化症:一例罕见且不幸的病例。

Multiple sclerosis following a spinal cord injury: a rare and unfortunate case.

作者信息

Salinas-González R S, Rodríguez-Sánchez L, Pelayo-Vergara R A, Benito-Penalva J

机构信息

Department of Medicine and Medical Specialties, Doctoral School, Health Sciences, University of Alcalá , Madrid, Spain.

Department of Physical Medicine and Rehabilitation, 'Hospital Comarcal de Monforte de Lemos' , Lugo, Spain.

出版信息

Spinal Cord Ser Cases. 2016 Jan 7;2:15027. doi: 10.1038/scsandc.2015.27. eCollection 2016.

Abstract

This is a case report and review of literature with the objective report of the case of a young man with physical disability following a traumatic spinal cord injury (SCI) who was later newly diagnosed with multiple sclerosis (MS) in an inpatient SCI rehabilitation center. (Barcelona, Spain). A 24-year-old male sustained a traumatic spinal cord lesion (T9 AIS A) as the result of a motorcycle accident. He completed his rehabilitation process without complications and returned to the community having adjusted to his new disability. Two and a half years after his initial injury, he attended the clinic after experiencing 2 months of paresthesias in his left hand, progressing to his right upper limb, and difficulty with fine hand movements. An magnetic resonance imaging (MRI) was arranged and although post-traumatic syringomyelia was ruled out, demyelinating areas in the cervical spinal cord were found. A brain MRI revealed multiple demyelinating lesions suggestive of MS. The diagnosis of MS was confirmed by a neurologist and treatment was started with daily doses of glatiramer acetate. At this time the patient was still independent in transfers, activities of daily living and wheelchair management. In young patients with SCI, adequate follow-up is important to detect subsequent complications that may lead to clinical and functional deterioration with a view to uncommon causes such as MS.

摘要

这是一篇病例报告及文献综述,目的是报告一名年轻男性的病例。该男性因创伤性脊髓损伤(SCI)导致身体残疾,后来在一家住院SCI康复中心(西班牙巴塞罗那)被新诊断为多发性硬化症(MS)。一名24岁男性因摩托车事故导致创伤性脊髓损伤(T9 AIS A)。他顺利完成康复过程,没有并发症,并在适应新残疾情况后重返社区。初始损伤两年半后,他因左手出现2个月感觉异常,后发展至右上肢,且手部精细动作困难而前来就诊。安排了磁共振成像(MRI)检查,虽然排除了创伤后脊髓空洞症,但在颈髓发现了脱髓鞘区域。脑部MRI显示多个脱髓鞘病变,提示为MS。神经科医生确诊为MS,并开始每日给予醋酸格拉替雷治疗。此时患者在转移、日常生活活动及轮椅操控方面仍保持独立。对于患有SCI的年轻患者,进行充分随访很重要,以便检测可能导致临床和功能恶化的后续并发症,尤其是像MS这样的罕见病因。

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