Cha Jun Min, Kim Hyoung Seop
Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Brain Neurorehabil. 2019 Mar 3;13(2):e11. doi: 10.12786/bn.2020.13.e11. eCollection 2020 Jul.
Cerebellar involvement in systemic lupus erythematosus (SLE) is rare, occurring in less than 2% of cases, with cerebellar atrophy on brain imaging even rarer. We describe a case of cerebellar atrophy in a patient with a history of SLE who underwent an intensive rehabilitation program and achieved functional improvement. A 26-years-old female with SLE felt difficult in balancing as well as dizziness and she took magnetic resonance imaging which showed cerebellar atrophy and positron emission tomography-computed tomography which showed markedly decreased signal intensity at bilateral temporal, parietal lobes, cerebellum and moderately at bilateral frontal lobes. A neurological examination showed bilateral nystagmus, intention tremor, bilateral dysmetria, and bilateral dysdiadochokinesia. Prior to the rehabilitation program, the patient's scores on the Berg Balance Scale (BBS) and Modified Barthel Index (MBI) were 4/56 and 37/100, respectively. The patient was hospitalized twice for rehabilitation treatment, which consisted of physical therapy, occupational therapy, therapeutic pool therapy, and robotic-assisted gait training. At discharge, the patient's BBS score was 9/56, and her MBI score was 46/100, and she was able to walk more than 20 m using an anterior walker. In the final 2 weeks before discharge, the patient was trained in the use of an electric wheelchair for outdoor activity.
小脑受累于系统性红斑狼疮（SLE）较为罕见，发生率不到2%，脑成像显示小脑萎缩的情况更为罕见。我们描述了一例有SLE病史的患者出现小脑萎缩，该患者接受了强化康复计划并取得了功能改善。一名26岁的SLE女性感到平衡困难以及头晕，她进行了磁共振成像，显示小脑萎缩，还进行了正电子发射断层扫描 - 计算机断层扫描，显示双侧颞叶、顶叶、小脑信号强度明显降低，双侧额叶信号强度中度降低。神经系统检查显示双侧眼球震颤、意向性震颤、双侧辨距不良和双侧轮替运动障碍。在康复计划之前，患者的伯格平衡量表（BBS）和改良巴氏指数（MBI）评分分别为4/56和37/100。该患者因康复治疗住院两次，治疗包括物理治疗、职业治疗、治疗池治疗和机器人辅助步态训练。出院时，患者的BBS评分为9/56，MBI评分为46/100，她能够使用前向助行器行走超过20米。在出院前的最后2周，患者接受了电动轮椅户外活动使用的训练。
