Suh Dae Chul, Jeong Soo, Choi Yun Hyeok, Cho Su Min, Yun Su Young, Son A Yeun, Lim Young Min, Kwon Boseong, Song Yunsun
Neurointervention Clinic, Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Neurointervention, GangNam St. Peter's Hospital, Seoul, Korea.
Neurointervention. 2022 Jul;17(2):93-99. doi: 10.5469/neuroint.2022.00129. Epub 2022 Jun 15.
Reversible aggravation of myelopathy symptoms was observed after the intake of taurine-rich foods in patients with venous congestive myelopathy (VCM) caused by a spinal arteriovenous shunt (SAVS), and the taurine-challenge test was applied to demonstrate an association between taurine and VCM.
The current study reviewed any aggravation history of myelopathy symptoms, including walking difficulty, after consuming taurine-rich foods among 133 consecutive patients with a SAVS from a prospective institutional database from June 2013 to February 2021. The type of taurine-rich foods, demographic data, arteriovenous shunt level, and follow-up periods were obtained. For the controlled taurine challenge test, Bacchus® (Dong-A Pharmaceutical, Seoul, Korea), a taurine-rich drink, was given to patients who fulfilled test criteria of recovered VCM (pain-sensory-motor-sphincter scale ≥2, improvement of spinal cord signal intensity on magnetic resonance imaging, and follow-up >6 months after SAVS treatment) to confirm the disappearance of such aggravation.
Ten patients had an aggravation history related to food. Webfoot octopus, small octopus, squid, crab, scallop, and taurine-rich energy drink (Bacchus®) were related to such aggravation in patients with VCM. Aggravation appeared about 30 minutes after food intake followed by expressions such as 'I could not walk and collapsed to the ground' and usually lasted for about 3 hours, followed by a slow recovery after taking rest. Four patients who met the test criteria underwent the taurine challenge with Bacchus® and revealed no further symptom aggravation, suggesting that taurine did not affect patients after recovery from VCM.
The association between taurine-rich food and reversible symptom aggravation can appear in patients with VCM and disappear after VCM treatment. Aggravation of venous hypertension in the spinal cord is suggested as a mechanism but further elucidation is needed.
在由脊髓动静脉分流（SAVS）引起的静脉充血性脊髓病（VCM）患者中，摄入富含牛磺酸的食物后观察到脊髓病症状出现可逆性加重，应用牛磺酸激发试验来证明牛磺酸与VCM之间的关联。
本研究回顾了2013年6月至2021年2月期间，来自一个前瞻性机构数据库的133例连续SAVS患者在食用富含牛磺酸的食物后脊髓病症状（包括行走困难）的任何加重病史。获取了富含牛磺酸食物的类型、人口统计学数据、动静脉分流水平和随访时间。对于对照牛磺酸激发试验，向符合VCM恢复试验标准（疼痛-感觉-运动-括约肌量表≥2、磁共振成像上脊髓信号强度改善、SAVS治疗后随访>6个月）的患者给予富含牛磺酸的饮料Bacchus®（韩国首尔东亚制药），以确认此类加重情况是否消失。
10例患者有与食物相关的加重病史。望潮、小章鱼、鱿鱼、螃蟹、扇贝和富含牛磺酸的能量饮料（Bacchus®）与VCM患者的此类加重有关。加重情况在进食后约30分钟出现，随后出现诸如“我无法行走并摔倒在地”等表述，通常持续约3小时，休息后缓慢恢复。4例符合试验标准的患者接受了Bacchus®牛磺酸激发试验，未出现进一步的症状加重，表明牛磺酸对VCM恢复后的患者没有影响。
富含牛磺酸的食物与可逆性症状加重之间的关联可出现在VCM患者中，并在VCM治疗后消失。脊髓静脉高压加重被认为是一种机制，但需要进一步阐明。
