Vergani M I, Reimão R, Silva A M, Muskat M, Espósito S, Diament A
Department of Neurology, University of São Paulo School of Medicine, Brasil.
Arq Neuropsiquiatr. 1988 Jun;46(2):195-7. doi: 10.1590/s0004-282x1988000200012.
A 2 year old boy was admitted owing to a subacute episode of ataxic gait and hearing deficit. Computerized tomography (CT) was normal and cerebrospinal fluid (CSF) analysis revealed gamma globulins level of 15.4% (normal 7 to 14%). There was spontaneous remission after 7 months. At 5 years of age the boy incurred a second episode with predominantly right appendicular ataxia and tonic gaze deviation to the right side. CT showed a low-density lesion in the white matter adjacent to the right frontal horn. Visual and auditory evoked potentials were abnormal. CSF revealed a mild increase in gamma globulins level of 14.5% with an abnormal T lymphocyte subsets study. The combination of visual, cerebellar, brain stem and paraventricular lesions with clear remissions and exacerbations, supported by CT, CSF and evoked potentials findings suggests the diagnosis of multiple sclerosis even at this early age.
一名2岁男孩因亚急性共济失调步态和听力减退入院。计算机断层扫描(CT)结果正常,脑脊液(CSF)分析显示γ球蛋白水平为15.4%(正常范围7%至14%)。7个月后症状自发缓解。5岁时,该男孩再次发病,主要表现为右侧肢体共济失调和向右侧的强直性凝视偏差。CT显示右侧额角附近白质有低密度病变。视觉和听觉诱发电位异常。脑脊液显示γ球蛋白水平轻度升高至14.5%,T淋巴细胞亚群研究异常。视觉、小脑、脑干和脑室旁病变合并明显的缓解和加重,CT、脑脊液和诱发电位检查结果支持这一诊断,提示即使在这个早期年龄也可诊断为多发性硬化症。