Kataria Saurabh, Neupane Karun, Ahmed Zahoor, Rehman Usama, Asif Saba
Neurology and Neurocritical Care, University of Missouri Columbia, Columbia, USA.
Internal Medicine, Manipal College of Medical Sciences, Pokhara, NPL.
Cureus. 2020 Oct 18;12(10):e11017. doi: 10.7759/cureus.11017.
An intense itching localized to dermatomes is a rare symptom of multiple sclerosis (MS). Herein, we report a case of a 45-year-old female who presented with severe itching and tingling sensation, gait disturbance, and bilateral paresthesia for one week. She also had a history of multiple admission in the hospital due to recurrent walking abnormalities and numbness and tingling of both hands associated with intermittent psychiatric symptoms. The neurological examination revealed spastic quadriparesis with lower limb muscles affected more than the upper limbs, numbness, and sensory loss in the upper extremities in the glove and stocking pattern. Magnetic resonance imaging (MRI) revealed multiple small rounded periventricular plaques in both hemispheres and along the long axis of the corpus callosum (fluid-attenuated inversion recovery/FLAIR sequence), and cerebrospinal fluid analysis revealed the presence of oligoclonal bands, suggestive of MS. She was commenced on methylprednisolone and carbamazepine, leading to progressive resolution of her signs and symptoms. She was discharged with monthly natalizumab, and she was doing well on her follow-up.
局限于皮节的剧烈瘙痒是多发性硬化症（MS）的一种罕见症状。在此，我们报告一例45岁女性病例，该患者出现严重瘙痒和刺痛感、步态障碍以及双侧感觉异常达一周时间。她既往有多次因反复出现行走异常、双手麻木和刺痛并伴有间歇性精神症状而入院的病史。神经系统检查发现痉挛性四肢瘫，下肢肌肉受累程度超过上肢，上肢呈手套和袜套样麻木及感觉丧失。磁共振成像（MRI）显示双侧半球及沿胼胝体纵轴有多发性小的圆形脑室周围斑块（液体衰减反转恢复序列/FLAIR序列），脑脊液分析显示存在寡克隆带，提示为MS。她开始接受甲泼尼龙和卡马西平治疗，其体征和症状逐渐缓解。她出院时开始每月使用那他珠单抗，随访情况良好。
