Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Ann Clin Transl Neurol. 2020 Dec;7(12):2535-2537. doi: 10.1002/acn3.51181. Epub 2020 Nov 11.
A 30-year-old healthy man presents after a fall with diffuse weakness and pain and recent onset left eye ptosis in the setting of three weeks of progressive bilateral leg weakness, gait instability, and difficulty washing his hair due to upper extremity weakness. He had also developed stiffness in his neck and shoulders and uncontrollable muscle spasms. Exam was notable for ptosis, fatiguing weakness in extremities, increased tone, hyperreflexia with clonus, and spastic gait. A mediastinal mass was found on chest CT (Fig. 1), and biopsy confirmed an invasive thymoma with positive nodes. Serum testing was positive for antibodies to acetylcholine receptors as well as glutamic acid decarboxylase.
一位 30 岁健康男性，因摔倒后出现全身无力和疼痛，以及左眼近期出现上睑下垂，伴三周进行性双侧下肢无力、步态不稳和因上肢无力而难以洗头前来就诊。他还出现了颈部和肩部僵硬以及无法控制的肌肉痉挛。检查发现上睑下垂、四肢易疲劳无力、肌张力增高、腱反射亢进伴阵挛，以及痉挛步态。胸部 CT 发现纵隔肿块（图 1），活检证实为侵袭性胸腺瘤伴淋巴结阳性。血清检测显示乙酰胆碱受体抗体和谷氨酸脱羧酶抗体阳性。
