Tsujimoto Yuki, Hao Akihito, Sato Tatsuya, Hideyama Takuto, Shibuya Hideki, Shiio Yasushi
Department of Neurology, Tokyo Teishin Hospital.
Present address: Department of Neurology, Graduate School of Medicine, University of Tokyo.
Rinsho Shinkeigaku. 2018 Nov 28;58(11):677-681. doi: 10.5692/clinicalneurol.cn-001198. Epub 2018 Oct 27.
The case is a 75-year-old female. She had dysesthesia in the distal extremities and truncal ataxia, and they had progressed in two months. Neurological examination revealed the findings of segmental dysesthesia in the distal extremities, impaired deep sensations in the trunk and four limbs, and painful legs and moving toes (PLMT). After workup, she was diagnosed with small cell lung cancer and her blood sample was positive for anti-Hu antibody. We concluded that her neurological symptoms were attributable to sensory neuronopathy associated with paraneoplastic syndrome. No cases with PLMT caused by paraneoplastic syndrome have been reported so far. She had chemotherapy to lung cancer and Duloxetine without improvement of PLMT. On the other hand, intravenous immunoglobulin treatment improved lightening pain in the toes without improvement of moving toes.
该病例为一名75岁女性。她有远端肢体感觉异常和躯干共济失调，且在两个月内病情进展。神经系统检查发现远端肢体节段性感觉异常、躯干和四肢深部感觉受损以及腿部疼痛和移动脚趾（PLMT）。经过检查，她被诊断为小细胞肺癌，其血液样本抗Hu抗体呈阳性。我们得出结论，她的神经症状归因于副肿瘤综合征相关的感觉神经元病。迄今为止，尚未有副肿瘤综合征导致PLMT的病例报道。她接受了肺癌化疗和度洛西汀治疗，但PLMT并无改善。另一方面，静脉注射免疫球蛋白治疗减轻了脚趾疼痛，但移动脚趾的情况并无改善。
