Lebrun Christine, Cohen Mikael, Mondot Lydiane, Ayrignac Xavier, Labauge Pierre
Department of Neurology, Nice Cote d'Azur University and CHU Pasteur 2, Nice, France.
Department of Neuroradiology, Nice Cote d'Azur University and CHU Pasteur 2, Nice, France.
Neurol Ther. 2017 Dec;6(2):259-263. doi: 10.1007/s40120-017-0082-8. Epub 2017 Aug 24.
Progressive solitary sclerosis is characterized by an isolated central nervous system demyelinating lesion arising in the spinal cord and brainstem, responsible for progressive motor impairment. We describe the case of a 40-year-old patient treated for more than 2 years with high doses of biotin (CERENDAY) for progressive symptoms of solitary sclerosis, who presented asymptomatic new T2 white matter lesions on brain magnetic resonance imaging (MRI). As there is no treatment option for solitary sclerosis, high doses of biotin were proposed, but had no impact on the progression of motor deficit. As the brain MRI showed no evidence of T2 lesions during the 10 years before the introduction of biotin, the demonstration of dissemination over time with this treatment raises questions. High doses of biotin have shown efficacy in some patients with spinal progressive MS, but could reveal a latent inflammatory condition.
进行性孤立性硬化症的特征是在脊髓和脑干出现孤立的中枢神经系统脱髓鞘病变，导致进行性运动障碍。我们描述了一名40岁患者的病例，该患者因孤立性硬化症的进行性症状接受高剂量生物素（CERENDAY）治疗超过2年，其脑部磁共振成像（MRI）显示出现无症状的新T2白质病变。由于目前尚无针对孤立性硬化症的治疗方法，因此采用了高剂量生物素治疗，但对运动功能缺损的进展没有影响。在使用生物素之前的10年里，脑部MRI未显示T2病变迹象，而此次治疗过程中病变随时间扩散，这引发了一些问题。高剂量生物素在一些脊髓型进行性多发性硬化症患者中显示出疗效，但可能会揭示一种潜在的炎症状态。
