Cook J R
Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, Purdue University School of Veterinary Medicine, West Lafayette, Indiana.
Vet Clin North Am Small Anim Pract. 1988 May;18(3):581-92. doi: 10.1016/s0195-5616(88)50056-6.
Fibrocartilaginous embolism (FCE) is an acute myelopathy that affects primarily dogs and human beings, and occasionally other mammalian species. It is frequently associated with trauma or vigorous exercise; in dogs it tends to affect mature non-chondrodystrophoid and giant breeds. Signs are acute and frequently indicate a very lateralized or focal lesion within the spinal cord, with resultant disparities in sensory and motor function. Lower motor neuron disease is common and hyperesthesia is unusual. The primary differential diagnoses are concussive trauma and intervertebral disc herniation, but the acute onset of strongly lateralizing spinal cord deficits without hyperesthesia in a breed at risk is strongly suggestive of the FCE syndrome. Attention must be given to other systemic diseases that might also give rise to emboli in the absence of FCE. Diagnosis is based on history, clinical signs, and elimination of other differential diagnoses. Treatment is largely supportive, although high doses of methylprednisolone may be beneficial early in the course of the disease. Affected patients may make a functional recovery if deep pain sensation is preserved and there are not complete lower motor neuron signs in affected limbs or sphincters.
纤维软骨栓塞(FCE)是一种主要影响犬类和人类、偶尔也会影响其他哺乳动物物种的急性脊髓病。它常与创伤或剧烈运动有关;在犬类中,它往往影响成熟的非软骨发育不良和巨型品种。症状是急性的,常表明脊髓内有非常偏向一侧或局限性的病变,导致感觉和运动功能出现差异。下运动神经元疾病很常见,感觉过敏则不常见。主要的鉴别诊断是震荡性创伤和椎间盘突出,但在有风险的品种中,脊髓缺损强烈偏向一侧且无感觉过敏的急性发作强烈提示FCE综合征。必须注意在没有FCE的情况下也可能导致栓子形成的其他全身性疾病。诊断基于病史、临床症状以及排除其他鉴别诊断。治疗主要是支持性的,不过在疾病早期大剂量使用甲基强的松龙可能有益。如果保留深部痛觉,且受影响肢体或括约肌没有完全的下运动神经元体征,受影响的患者可能会功能恢复。