Ghosh R, Roy D, Mandal A, León-Ruiz M, Das S, Dubey S, Jana A, Purkait S, Ghosh T, Benito-León J
Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, West Bengal, India.
Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India.
Neurol Perspect. 2024 Jan-Mar;4(1). doi: 10.1016/j.neurop.2023.100138. Epub 2023 Nov 30.
Myeloneuropathy is a diagnosis ascribed to disorders that concomitantly affect the spinal cord and peripheral nerves. Recognizing this syndrome may sometimes be arduous, even for the most consummate clinicians, because symptomatology can mimic either spinal cord or peripheral nerve disease. Besides, examination findings suggest a predominantly myelopathic or neuropathic picture. This article reports a rendezvous of rare cases of clinically diagnosed myeloneuropathy with different etiological backgrounds and therapeutic responses.
Eleven cases of non-compressive myeloneuropathy were admitted to the Department of General Medicine of Burdwan Medical College and Hospital, Burdwan, West Bengal, India, between May 2018 and May 2022.
We report the cases of 11 patients (6 men and 5 women) who presented with myeloneuropathy of different etiologies (vitamin B12, copper, and vitamin E deficiencies, organophosphate poisoning, chronic alcohol abuse, illicit substances abuse, anti-thyroid peroxidase/anti-thyroglobulin antibody-related neurologic disorder responsive to steroids, Sjögren syndrome, chikungunya infection, paraneoplastic, and hereditary).
Meticulous historical analysis, careful clinical examination, and apposite utilization and interpretation of biochemical, electrophysiological, and neuroimaging findings are sine-qua-non for an accurate and consistent approach to evaluating a suspected case of myeloneuropathy, facilitating early treatment and recovery. Differential identification of these disorders needs an in-depth perception of the mode of onset of symptoms, the course of progression of the disease, the pattern of myelopathic/neuropathic findings, and recognition of other neurological or systemic manifestations. For untroubled understanding, etiologies of myeloneuropathies should be subdivided into a few broad categories, e.g., metabolic (nutritional), toxic (toxin-induced), infectious, inflammatory (immune-mediated), paraneoplastic, and hereditary disorders.
脊髓神经病是一种归因于同时影响脊髓和周围神经的疾病的诊断。即使对于最有经验的临床医生来说，识别这种综合征有时也可能很困难，因为其症状可能类似于脊髓疾病或周围神经疾病。此外，检查结果提示主要为脊髓病或神经病表现。本文报告了一组临床诊断为脊髓神经病的罕见病例，其病因背景和治疗反应各不相同。
2018年5月至2022年5月期间，印度西孟加拉邦布尔万医学院和医院普通内科收治了11例非压迫性脊髓神经病患者。
我们报告了11例患者（6名男性和5名女性）的病例，他们患有不同病因的脊髓神经病（维生素B12、铜和维生素E缺乏、有机磷中毒、慢性酒精滥用、非法物质滥用、抗甲状腺过氧化物酶/抗甲状腺球蛋白抗体相关的对类固醇有反应的神经系统疾病、干燥综合征、基孔肯雅热感染、副肿瘤性和遗传性）。
细致的病史分析、仔细的临床检查以及对生化、电生理和神经影像学检查结果的恰当运用和解读，是准确、一致地评估疑似脊髓神经病病例以促进早期治疗和康复的必要条件。对这些疾病进行鉴别诊断需要深入了解症状的发作方式、疾病的进展过程、脊髓病/神经病表现的模式以及对其他神经系统或全身表现的认识。为便于理解，脊髓神经病的病因应细分为几大类，例如代谢性（营养性）、中毒性（毒素诱导性）、感染性、炎症性（免疫介导性）、副肿瘤性和遗传性疾病。
