Hara H, Wakayama Y, Yamada H, Kouno Y, Kawasaki H
Department of Medicine, Showa University Fujigaoka Hospital.
Rinsho Shinkeigaku. 1994 Jul;34(7):717-9.
A 24-year-old woman with SLE since the age of 12 developed sensory-motor peripheral neuropathy in 1990. Her sensory neuropathy was symmetrical in all limbs and distally dominant. Electrophysiological study showed marked reduction of motor and sensory conduction velocities. Sural nerve biopsy revealed vasculitis and axonopathy. Symptoms of neuropathy and nerve conduction velocities were improved by high dose steroid treatment. After one year she had a fever of unknown origin, and then presented limb myokymia with involuntary finger movement which was fine, irregular, and continuous. Needle EMG revealed myokymic discharge at dorsal interosseous and flexor pollicis brevis muscles. Because myokymia was increased by hyperventilation and suppressed by local anesthesia at the wrist, her myokymia was thought to originate in the peripheral nerve. This is the first case report of limb myokymia with finger involuntary movement caused by peripheral neuropathy due to SLE.
一名自12岁起患系统性红斑狼疮(SLE)的24岁女性于1990年出现感觉运动性周围神经病变。她的感觉神经病变在所有肢体均呈对称性,且以远端为主。电生理研究显示运动和感觉传导速度明显降低。腓肠神经活检显示血管炎和轴索性病变。高剂量类固醇治疗使神经病变症状和神经传导速度得到改善。一年后,她出现不明原因发热,随后出现肢体肌束震颤,并伴有手指不自主运动,运动精细、不规则且持续。针电极肌电图显示背侧骨间肌和拇短屈肌有肌束震颤放电。由于过度通气会加重肌束震颤,而手腕局部麻醉可抑制该症状,因此认为她的肌束震颤起源于周围神经。这是首例关于SLE所致周围神经病变引起肢体肌束震颤伴手指不自主运动的病例报告。