Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, Karnataka, India.
Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, Karnataka, India.
Mult Scler Relat Disord. 2022 Feb;58:103463. doi: 10.1016/j.msard.2021.103463. Epub 2021 Dec 16.
Exclusive emesis has been observed in few patients of MOG-associated disorder (MOGAD).
To study the occurrence of emesis in patients of Demyelinating disorders and determine their clinical and radiological features.
Medical records of 551 patients of CNS demyelinating disorders were reviewed. Exclusive emesis without hiccups was observed in 1 (0.1%) patient of MS, 17 (6.5%) patients of MOGAD while none were observed in patients of AQP4-ab associated disorders (p < 0.001). There were 17(M:F-8:9) patients with exclusive emesis in MOGAD in 58.8% pediatric age group, adults (35.3%) and late-onset (5.9%). ADEMON (acute demyelinating encephalomyelitis -ADEM followed by optic neuritis) was observed in 7 patients. Preceding clinical syndrome was ON (41.2%), brainstem syndrome (BS) (23.5%), involvement of both ON and BS in 23.5%, myelopathy (11.8%). MRI analysis showed combination of lesions affecting the brainstem (11), optic nerve (10), juxtacortical white matter (10) and periventricular lesions (3). Odds ratio for the presence of ADEM, lesions in medulla, pons, MCP or any of the three areas was found to be significant.
Exclusive emesis without hiccups appears to be common in MOG-antibody associated disorder and may occur as a prodromal illness or exclusive clinical episode. It is known to occur most commonly in association with ADEM and/or Optic neuritis.
MOG 相关性疾病（MOGAD）患者中很少观察到呕吐。
研究脱髓鞘疾病患者呕吐的发生情况，并确定其临床和影像学特征。
回顾了 551 例中枢神经系统脱髓鞘疾病患者的病历。在 MS 患者中观察到 1 例（0.1%）、MOGAD 患者中观察到 17 例（6.5%）患者出现呕吐而无呃逆，在 AQP4-ab 相关疾病患者中则未观察到（p<0.001）。在 MOGAD 中，有 17 例（17 例患者为女性，17 例患者为男性）患者出现呕吐，其中 58.8%为儿童期发病，成人（35.3%）和迟发性（5.9%）。观察到 7 例 ADEMON（急性脱髓鞘性脑脊髓炎-ADEM 后伴视神经炎）。前临床综合征为 ON（41.2%）、脑干综合征（BS）（23.5%）、ON 和 BS 均受累（23.5%）、脊髓病变（11.8%）。MRI 分析显示，病变影响脑干（11 例）、视神经（10 例）、皮质下白质（10 例）和脑室周围病变（3 例）。发现 ADEM、延髓、脑桥、MCP 或任意三个区域存在病变的比值比具有显著意义。
无呃逆的呕吐似乎在 MOG 抗体相关疾病中很常见，可能作为前驱疾病或单一临床发作出现。已知最常与 ADEM 和/或视神经炎相关。
