Ungureán A, Pálfi S, Dibó G, Tiszlavicz L, Vécsei L
Department of Neurology, Szent-Györgyi University Medical School, Szeged, Hungary.
Funct Neurol. 1996 Jul-Aug;11(4):209-14.
The simultaneous occurrence of multiple sclerosis and transverse myelitis is known in the literature. Apart from the spinal symptoms, other neurological signs of brain involvement are usually found and magnetic resonance imaging (MRI) reveals disseminated foci in the brain. The positive evoked responses, the immunological abnormalities of the cerebrospinal fluid (CSF), and the oligoclonality together prove the presence of multiple sclerosis. In these cases the symptoms of transverse myelitis can separately precede other signs of multiple sclerosis, or appear as a relapse. Recurrent transverse myelitis as an independent entity, with negative MRI and CSF immunology, is an exciting topic in terms of the etiological factors and therapeutic considerations. The view in the literature is that the occurrence of transverse myelitis as an independent entity is rather rare. The present article reports the case of a female patient with recurrent spinal cord signs, and negative MRI and CSF immunology. During a ten-year follow-up observation period, symptoms of multiple sclerosis did not develop. Further studies of such cases are needed in order to clarify the etiological factors, the pathomechanism and the therapeutic considerations relating to this relatively new and probably independent clinical entity.
文献中已知多发性硬化症和横贯性脊髓炎会同时出现。除了脊髓症状外,通常还会发现脑部受累的其他神经学体征,并且磁共振成像(MRI)显示脑部有散在病灶。阳性诱发电位、脑脊液(CSF)的免疫异常以及寡克隆性共同证明了多发性硬化症的存在。在这些病例中,横贯性脊髓炎的症状可以先于多发性硬化症的其他体征单独出现,或者表现为复发。复发性横贯性脊髓炎作为一个独立的实体,MRI和CSF免疫学检查呈阴性,就病因和治疗考虑而言是一个令人关注的话题。文献中的观点是,横贯性脊髓炎作为一个独立实体的发生相当罕见。本文报道了一名有复发性脊髓体征、MRI和CSF免疫学检查呈阴性的女性患者病例。在为期十年的随访观察期内,未出现多发性硬化症的症状。需要对这类病例进行进一步研究,以阐明与这个相对较新且可能独立的临床实体相关的病因、发病机制和治疗考虑因素。