Sudo K, Owada Y, Yabe I, Kikuchi S, Tashiro K
Department of Neurology, Hokkaido University School of Medicine, Sapporo, Japan.
Lancet. 1996 Jun 8;347(9015):1593-5. doi: 10.1016/s0140-6736(96)91078-8.
Among 26 patients with communicating syringomyelia who came to our out-patient clinic from April, 1989, to March, 1995, three (11.5%) had hypertrophy in limbs, hands, or feet. One had crossed hypertrophy. We considered the possibility that syringomyelia caused body hypertrophy.
We searched MEDLINE for articles which mention body asymmetry or hypertrophy, and examined the findings in our own patients.
The site of hypertrophy in our three patients coincided with the site of the neurological and magnetic resonance imaging findings. In addition, the horizontal and vertical location of the syrinx corresponded with the site of all four hypertrophic limbs. We located ten articles in which a diagnosis of syringomyelia was made, and five in which other diagnoses were made.
From studying our patients as well as those previously reported, we speculate that some types of body hypertrophy are due to damage, accompanied by stimulation, of the sympathetic neurons in the ipsilateral lateral horn of the spinal cord. Although there are many causes of hypertrophy, we suggest that the possibility of syringomyelia be investigated in patients with body hypertrophy, especially in those with any accompanying neurological abnormality.
在1989年4月至1995年3月期间到我院门诊就诊的26例交通性脊髓空洞症患者中,有3例(11.5%)出现肢体、手部或足部肥大。1例为交叉性肥大。我们考虑了脊髓空洞症导致身体肥大的可能性。
我们在MEDLINE上搜索提及身体不对称或肥大的文章,并检查了我们自己患者的检查结果。
我们3例患者的肥大部位与神经学和磁共振成像结果的部位一致。此外,脊髓空洞的水平和垂直位置与所有4条肥大肢体的部位相对应。我们找到了10篇做出脊髓空洞症诊断的文章,以及5篇做出其他诊断的文章。
通过对我们的患者以及先前报道的患者进行研究,我们推测某些类型的身体肥大是由于脊髓同侧侧角交感神经元受损并伴有刺激所致。尽管肥大有多种原因,但我们建议对身体肥大的患者,尤其是伴有任何神经学异常的患者,进行脊髓空洞症的可能性调查。