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纵向广泛横贯性脊髓炎的综合康复:一个复杂病例的研究

Integrated Rehabilitation of Longitudinal Extensive Transverse Myelitis: Study of a Complex Case.

作者信息

Qureshi Muskan G, Harjpal Pallavi, Nawkhare Anjali V, Saklecha Akshaya, Seth Nikita H

机构信息

Department of Neuro Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Sep 6;16(9):e68778. doi: 10.7759/cureus.68778. eCollection 2024 Sep.

DOI:10.7759/cureus.68778
PMID:39371736
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11456256/
Abstract

Longitudinal extensive transverse myelitis (LETM) is a rare neurological disorder portrayed by inflammation of the spinal cord spanning three or more vertebral segments. It can lead to severe symptoms such as weakness, sensory abnormalities, and dysfunction in various parts of the body. LETM can be idiopathic or associated with autoimmune conditions like Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO). Diagnosis of LETM requires MRI imaging of the spine, and treatment often involves corticosteroids, intravenous immunoglobulins (IVIG), and plasma exchange. Physical therapy plays a crucial role in managing LETM, focusing on improving functional abilities, mobility, and quality of life. This study outlines a 62-year-old male who was admitted with a complaint of bilateral weakness of both upper and lower limbs, predominantly on the left side, seizures, falls, and stiffness of the left limbs. He also complained of a cough with sputum, cluster headache, bowels and bladder dysfunction, and impaired vision. Neurologic examination showed hypotonia and reduced muscle strength in all four limbs with impairment of the optic nerve. The following investigations were conducted: MRI, Chest X-ray, and ultrasound. He was advised for physiotherapy, after which he showed improvement in functional independence and a general recovery following the treatment.

摘要

纵向广泛横贯性脊髓炎(LETM)是一种罕见的神经系统疾病,其特征是脊髓炎症跨越三个或更多椎体节段。它可导致严重症状,如虚弱、感觉异常以及身体各部位功能障碍。LETM可以是特发性的,也可与自身免疫性疾病如多发性硬化症(MS)和视神经脊髓炎(NMO)相关。LETM的诊断需要进行脊柱MRI成像,治疗通常包括使用皮质类固醇、静脉注射免疫球蛋白(IVIG)和血浆置换。物理治疗在LETM的管理中起着关键作用,重点是提高功能能力、活动能力和生活质量。本研究概述了一名62岁男性,他因双上肢和双下肢双侧无力(主要在左侧)、癫痫发作、跌倒以及左侧肢体僵硬而入院。他还主诉咳嗽伴咳痰、丛集性头痛、肠道和膀胱功能障碍以及视力受损。神经系统检查显示四肢肌张力减退、肌肉力量减弱以及视神经受损。进行了以下检查:MRI、胸部X光和超声检查。他接受了物理治疗建议,治疗后其功能独立性有所改善并总体康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/c4bc0dc96c81/cureus-0016-00000068778-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/e53651a5fefd/cureus-0016-00000068778-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/4867ccb89f3f/cureus-0016-00000068778-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/c79aacffdffa/cureus-0016-00000068778-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/9aaeb1a93da8/cureus-0016-00000068778-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/c4bc0dc96c81/cureus-0016-00000068778-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/e53651a5fefd/cureus-0016-00000068778-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/4867ccb89f3f/cureus-0016-00000068778-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/c79aacffdffa/cureus-0016-00000068778-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/9aaeb1a93da8/cureus-0016-00000068778-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b093/11456256/c4bc0dc96c81/cureus-0016-00000068778-i05.jpg

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本文引用的文献

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J Neurol. 2023 Jul;270(7):3341-3368. doi: 10.1007/s00415-023-11634-0. Epub 2023 Apr 6.
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Physiotherapy management of acute transverse myelitis in a pediatric patient in a Nigerian hospital: a case report.尼日利亚医院中一例小儿急性横贯性脊髓炎的物理治疗管理:病例报告。
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Longitudinally extensive transverse myelitis in childhood: Clinical features, treatment approaches, and long-term neurological outcomes.
儿童长节段横贯性脊髓炎:临床特征、治疗方法和长期神经预后。
Clin Neurol Neurosurg. 2021 Aug;207:106764. doi: 10.1016/j.clineuro.2021.106764. Epub 2021 Jun 17.
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